Objective To report the development and validation of the National Cancer Center Psychological Symptom Inventory (NCC‐PSI). Methods Psychometric properties of the NCC‐PSI were examined by using multicenter surveys involving 400 patients with cancer in 5 cancer‐treatment hospitals throughout Korea. Related measures including the Mini‐International Neuropsychiatric Interview were administered. Results Convergent validity was supported by NCC‐PSI's significant associations with related measures. Known‐group validity was proven with higher scores of helplessness/hopelessness and anxious preoccupation on the Mini‐Mental Adjustment to Cancer in the depression and anxiety diagnosis group, defined by the NCC‐PSI. Cutoff scores for insomnia, anxiety, and depression were identified. Overall, the screening performance of the NCC‐PSI was comparable to that of the distress thermometer and Patient Health Questionnare‐2. Conclusions The NCC‐PSI represents a meaningful effort to develop a distress screening tool that addresses specific psychological symptoms common in cancer, which are tailored to the local oncology care system with varying degrees of psychosocial care resources.