AbstractDiquat (DQ) is a nonselective quick-acting herbicide, which can directly contaminate humans and the environment during improper use and production. The early diagnosis of DQ poisoning allows for patients to receive timely treatment. Here, a novel monoclonal antibody was screened based on the rational design and synthesis of a DQ hapten and complete antigen. With the custom-designed anti-DQ antibody, we developed a stable and specific immunochromatographic strip to recognize DQ within 10 ∼ 15 min in various biological samples. The test strips could recognize DQ at concentrations as low as 20 ng/mL and be read by the naked eye, reaching the detection level of liquid chromatography-mass spectrometry. Moreover, quantitative methods involving the use of immunochromatographic strips and ELISA were developed to continuously monitor DQ concentrations. DQ and paraquat (PQ) joint test strips were developed to simultaneously measure DQ and PQ. Notably, the clinical performance of the proposed test strips was evaluated in multiple hospitals and public health agencies. Taken together, our study provides the first clinical DQ-targeted colloidal gold immunochromatographic test strips with excellent performance, which are expected to be useful for clinical practice, environmental monitoring, food safety and scientific research.