Background <p>Undergraduate anesthesia nursing students are a vital segment of China’s anesthesia nursing workforce, and their core competency levels are directly linked to patient safety and the quality of medical services. However, the core competence index system for undergraduate anesthesia nursing graduates has not been established in China.</p> Objective <p>To establish a core competence index system for undergraduate anesthesia nursing graduates.</p> Methods <p>Through literature review and semi-structured interviews (<i>n</i> = 8), a preliminary index system was established under the guidance of Hauenstein’s taxonomy of educational objectives. The Delphi technique (<i>n</i> = 16) was employed to finalize the index system, with weights assigned to each index using the Analytic Hierarchy Process. Expert consensus criteria were set as follows: mean importance score (Mj) ≥ 3.5, coefficient of variation (CV) ≤ 0.25, full-score rate ≥ 20%.</p> Results <p>The effective recovery rates of the two rounds of questionnaires were both 100%, and the expert authority coefficients were 0.940 and 0.947 respectively. Kendall’s coefficients of coordination of the indexes at all levels in the 2 rounds of consultation were 0.289–0.375 and 0.323–0.387, respectively (<i>P</i> &lt; 0.001). The final core competence index system for undergraduate anesthesia nursing graduates contains 4 first-level indexes (cognitive domain, emotional domain, skill domain, and behavioral domain), 17&#xa0;second-level indexes, and 125 third-level indexes.</p> Conclusions <p>The constructed index system of the core competencies for core competences in undergraduate anesthesia nursing is both scientific and comprehensive, potentially serving as a reference for the training and assessment of undergraduate anesthesia nursing graduates.</p> Clinical trial number <p>Not applicable.</p>