Background <p>As the population of elderly patients with chronic musculoskeletal pain (CMP) grows, the relationship between pain and exercise behavior has garnered widespread interest. This study aims to localize the BioPMovQ and examine its reliability and validity among elderly CMP patients.</p> Methods <p>A total of 526 elderly patients with CMP were recruited from the Orthopedics Department of a tertiary hospital in Shanxi Province. After obtaining permission from the original author, the BioPMovQ was translated into Chinese following the Brislin translation principles. This study explored item-level differences through item analysis; it used the Delphi method to analyze content validity, and used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to explore and verify the potential factor structure of the scale; it also calculated internal consistency reliability and assessed test-retest reliability to evaluate the scale’s reliability.</p> Results <p>A total of 16 items were retained for project analysis. The content validity index (I-CVI) at the item level of BioPMovQ was 0.857～1.000, and the content validity index (S-CVI) at the questionnaire level was 0.937. In EFA, four common factors were extracted, including disability, self-efficacy for physical activity, movement avoidance behaviours, and self-perceived functional ability, which explained 68.870% of the total variance. The CFA results showed that, χ2/df=2.083, GFI=0.913, NFI=0.902, TLI=0.934, CFI=0.946, IFI=0.947, RMSAE=0.064. The Cronbach's alpha coefficient, split half reliability, and test-retest reliability of the Chinese version of BioPMovQ are 0.844, 0.905, and 0.852, respectively.</p> Conclusions <p>The Chinese version of BioPMovQ has good reliability and validity, and can be used to measure the relationship between pain and various factors related to exercise behavior in elderly patients with CMP from a biological behavioral perspective.</p>