Background: Scale development or tool development is an important area of interest in health research. Psychologically validated tools have made it possible to measure various variables which are not amenable for observation to get evaluated. Development and evaluation of the instrument should be carried out with absolute diligence, as the health measures evaluated through them becomes the basis for many health policies and program delivery. However, the novice researchers find it cumbersome to go through the stringent process in developing a tool which results in less efficient tools which are unable to capture the whole construct. Henceforth the current literature review was undertaken to contribute substantial information on tool development to the scientific world at large. Methods: A comprehensive search was conducted across different databases namely PUBMED, INDMED, Scopus, MEDLINE with the following MESH keywords; test construction, scale development, item analysis and instrument validation. Potential full-text articles were retrieved followed by a narrative synthesis of data from various articles. Results: A wide disparity was observed in the steps observed by different authors in the development of the tool. However, the general steps in the development of tool can be summarized as follows; gap identification, conceptualization, choice of the measurement method, development of measures, scale evaluation and refinement and validation. Conclusion: If a clinical or educational practice is to be enhanced or changed using findings derived from questionnaire/scale-based methods, the questionnaire must be sufficiently developed.