Objectives: To establish a valid and reliable translated version of Derriford Appearance Scale (DAS59) for Nepali population. Methods: A standard translation-back-translation procedure was used followed by evaluation of semantic, conceptual and society equivalence by the committee and changes were made according to recommendations. This corrected version was pretested and a final version was developed. A validation study was performed using the final version on 424 patients including 212 patients with clinical appearance problems and similar number of young adults who had no concern for facial appearance. Reliability was assessed by Cronbach’s alpha value and test-retest correlation coefficient. Discriminate and convergent validity were assessed by comparison between clinical and normal population and correlation with Beck’s Anxiety Inventory (BAI), Beck’s Depression Inventory (BDI) and General Health questionnaire (GHQ). Results: The results indicated excellent internal consistency (Cronbach’s alpha = 0.98) and good test-retest reliability (0.91 for clinical population, 0.86 for normal population). The Discriminate validity was good with statistically significant differences between clinical and normal population. The convergent validity was confirmed by good correlation with other related psychometric tools. Conclusion: A valid and reliable Nepali DAS59 version was developed which can be used for research and clinical assessment of patients with appearance problems and concerns.