Introduction: This study aimed to develop the Healthy Eating Report Card for Pre-school Children in Hong Kong for evaluating the prevalence of healthy eating behaviours and favourable family home food environments (FHFEs) among pre-school children in Hong Kong. Methods: In this cross-sectional study, 538 parent-child dyads from eight kindergartens in Hong Kong were recruited. Parents or guardians completed a questionnaire comprising Report Card items. The Report Card included two indicators of Children’s Eating Behaviours (ie, Children’s Dietary Patterns and Children’s Mealtime Behaviours) and three indicators of FHFEs (ie, Parental Food Choices and Preparation, Avoidance of Unhealthy Foods, and Family Mealtime Environments). Each indicator and its specific items were assigned a letter grade representing the percentage of participants achieving the predefined benchmarks. The grades were defined as A (≥80%, Excellent); B (60%-79%, Good); C (40%-59%, Fair); D (20%-39%, Poor); and F (<20%, Very poor). Plus (+) and minus (-) signs were used to indicate the upper or lower 5% of each grade. Results: Overall, Children’s Eating Behaviours were classified as Fair (average grade of ‘C’), whereas FHFEs were classified as Good (average grade of ‘B’). The sub-grades ranged from ‘C’ to ‘A-’, as follows: Children’s Dietary Patterns, ‘C+’; Children’s Mealtime Behaviours, ‘C’; Parental Food Choices and Preparation, ‘C+’; Avoidance of Unhealthy Foods, ‘B’; and Family Mealtime Environments, ‘A-’. Conclusion: The findings highlight areas for improvement in healthy eating among children. The Healthy Eating Report Card could offer novel insights into intervention tools that promote healthy eating. Copyright © 2024 Hong Kong Academy of Medicine.