Objective To scientifically construct a self-management behavior scale for postoperative patients with osteoporotic fractures, in order to assess the self-management behavior level of this patient population. Methods Between November 2022 and February 2023, a scale item pool was constructed using literature analysis and expert panel discussions. A preliminary version of the scale was formed based on feedback from 30 experts and 15 patients. From March 2023 to March 2024, a convenience sampling method was used to survey 230 patients post-osteoporotic fracture surgery from a tertiary hospital in Guangzhou. Cronbach’s α coefficient, split-half reliability, and test-retest reliability were used to assess the reliability of the scale, while content validity and exploratory factor analysis were used to evaluate its validity. Results The developed scale consisted of 5 dimensions and 27 items. The content validity index for each item ranged from 0.933 to 1.000. Exploratory factor analysis extracted 5 common factors, explaining 65.964% of the cumulative variance. The overall Cronbach’s α coefficient, split-half reliability, and test-retest reliability were 0.934, 0.780, and 0.958, respectively. The Cronbach’s α coefficient, split-half reliability, and test-retest reliability for each dimension ranged from 0.849 to 0.897, 0.816 to 0.904, and 0.826 to 0.894, respectively. Conclusions The self-management behavior scale for post-osteoporotic fracture surgery patients demonstrates good reliability and validity. It is a highly authoritative and scientific tool that can be used effectively to assess self-management behaviors in these patients and provide a basis for developing personalized self-management interventions.