Objective To design a pocket book on picture-aided communication in foreign-related nursing and to verify the clinical effect.Methods Contents of this pocket book were collected by literature retrieval and qualitative interview,and were improved by a two-round Delphi expert consultation. Comparison was conducted between patients in the experiment group and control group,each with 25 foreigners,about their communication time and satisfaction.Results In A pocket book on picture-aided communication in foreign-re-lated nursing,5 dimensions with 620 entries were included,with test-retest reliability of 0.816,and content validity 0.97. It was shown in clinical application that this pocket book could effectively improve communication efficiency and satisfaction between nurses and foreign patients (P<0.05).Conclusions A pocket book on pic-ture-aided communication in foreign-related nursing can help develop fast and effective communication between nurses and foreign patients,improve service quality of foreign-related nursing,and give a hand to develop level of international medical service in Shanghai.