Purpose <p>Feeding challenges in ASD, including food selectivity, sensory sensitivities, and disruptive behaviors, can negatively impact nutrition, development, and family dynamics. Existing tools often fail to evaluate feeding behaviors across distinct domains and environmental contexts with cultural sensitivity. This study aimed to develop and validate the Autism Mealtime Behavior Questionnaire (AMBQ) to assess feeding difficulties in Asian children with ASD aged 2 to 8 years.</p> Methods <p>Fifty parents of children with autism spectrum disorder (ASD) completed the AMBQ to evaluate its reliability and validity, with 25 parents repeating it after two weeks to assess test-retest reliability.</p> Results <p>The psychometric analysis results of the AMBQ demonstrated satisfactory reliability in both of the frequency domain (Cronbach alpha = 0.72, inter-rater consistency = 0.96, percentage of minimum detectable change = 12.26%) and distress domain (Cronbach alpha = 0.72, inter-rater consistency = 0.88, percentage of minimum detectable change = 18.43%). Meanwhile, convergent validity analysis revealed moderate to strong correlation between the AMBQ and the Brief Autism Mealtime Behavior Inventory (BAMBI), with correlation coefficients of 0.60 for the frequency domain and 0.78 for the distress domain.</p> Conclusion <p>Our findings support the AMBQ as a reliable and valid tool for assessing mealtime behaviors and associated parental distress in children with ASD.</p>