Introduction Electronic cigarette use has gained popularity among Malaysian adult smokers. Yet, there is limited research on adult perception of e- cigarette use. The aim of thi s s tudy was to develop a tool to measure adults’ perception of e-cigarette (EC) use called the Electronic Cigarette Use Perception Instrument (ECUPI). Methodology [Refer to Results]. Results Data were collected from 1247 adults who participated in a hospital-based study in Malaysia, more than two thirds of respondents were male, a majority (65.9%) were Malay. Discussion and Conclusion The ECPT showed good validity and reliability for measurement of perception of e-cigarette use among adults in Malaysia and therefore a viable measure for assessing e- cigarette perception among adults.