Purpose The aim of this study is to develop a Spanish version of the Body Image Scale (Hopwood et al. Eur J Cancer 37(2):189–197, 2001 ) and to analyze its psychometric properties in a sample of women with breast or gynaecological cancer. Methods The Spanish version of the Body Image Scale was developed using a forward and backward translation technique . A total sample of 100 women who had undergone radical surgery for breast ( n  = 50) or gynaecological cancer ( n  = 50) completed the scale. Results Factor analysis resulted in a single-factor solution, both in the total sample and in the two subgroups, accounting for >76 % variance. Internal consistency (Cronbach’s alpha) was 0.960. The Spanish version of the Body Image Scale correlated negatively with self-esteem ( r  = −0.733), quality of life ( r  = −0.632) and age ( r  = −0.643) and positively with depression ( r  = 0.832) and anxiety ( r  = 0.564); all p values <0.01. Conclusions To our knowledge, this is the first study that provides a Spanish version of the Body Image Scale. Our results show a stable factorial structure between samples with a single-factor solution and good psychometric properties, suggesting that it is a suitable tool for measuring body image concerns among Spanish-speaking cancer patients. Its brevity and comprehensibility allow a quick assessment both in clinical and research settings.