Leptospirosis, a potentially fatal bacterial infection, is endemic in tropical and sub-tropical countries. Agricultural workers are at greater risk because of their increased contact with the environment. This study aimed todevelop a leptospirosis screening index for oil palm plantation workers.Itinvolved 350 oil palm plantation workers in southern Malaysia usingan interviewer-guided questionnaire and serological microscopic agglutination test (MAT) with cut-off titre for seropositive at ≥1:100.A new 13-point screening index was developed based on six significant leptospirosis associated factors of ‘fruit collector job’,‘did not wear rubber glove PPE’, ‘working with the presence of hand wound’, ‘did not wash hands with soap after work before eating or drinking’, ‘presence of cows in the plantation’ and ‘presence of a landfill site in the plantation’. The screening index has good discriminatory power of 83.9 percent.The newly-developed evidence-based screening index will likely help identify which of the many Malaysian oil palm plantation workers are most at risk of leptospirosis infection.