Backgrounds <p>Positive psychology offers a promising framework for enhancing mental health, particularly among maintenance hemodialysis (MHD) patients, whose psychological well-being is often compromised. This study aimed to develop and validate a Chinese version of the PERMA Profiler, tailored to assess flourishing in MHD patients and provide a reliable research tool.</p> Methods <p>Following the translation and cultural adaptation of the original PERMA Profiler, 376 MHD patients were surveyed to assess its psychometric properties. Analyses included item analysis, exploratory and confirmatory factor analysis, criterion validity, and reliability testing.</p> Results <p>The Chinese version retained all original items and exhibited strong psychometric properties. By validity analysis, the KMO value was 0.871. Factor analysis identified two dimensions: positive experience and self-actualization, accounting for 57.7% of the variance. Model fit indices (<i>χ</i>²/df = 3.23, RMSEA = 0.095) were acceptable. The scale showed strong internal consistency (Cronbach’s <i>α</i> = 0.914) and test-retest reliability (<i>r</i> = 0.764).</p> Conclusion <p>The PERMA Profiler, adapted for a Chinese cultural context, is a reliable and valid tool for assessing flourishing in MHD patients. It offers a robust foundation for research and intervention to improve mental health outcomes in this population.</p>