Purpose: The purpose of this study was to develop a scale to evaluate stress in elderly patients with coronary artery diseases (CAD) andto examine validity and reliability of the scale. Methods: The development process for the preliminary scale included construction of aconceptual framework and initial items, verification of content analysis, sentence correction, and pilot study. This study was conductedusing a questionnaire survey with one-to-one interviews during January and February, 2012. Participants were 240 elderly patients withCAD. Data were analyzed using item analysis, factor analysis, criterion related validity, and internal consistency. Results: The developedscale consisted of 32 items and 6 factors - aging and disease (7 items), family relations (5 items), anxiety and withdrawal (9 items), managementof daily living (3 items), compliance of medical regimen (4 items), poverty and finance (4 items), and explained 68.5% of totalvariance. The scale had significantly positive correlation with the Korean Perceived Stress Scale (KPSS). Cronbach’s alpha was .96, andGuttman split half coefficient was .91. Conclusion: Results indicate that the Stress Scale for Elderly Patients with CAD has validity andreliability, and is a suitable scale in health care settings to assess stress in elderly patients with CAD.