As a generalization of intuitionistic fuzzy sets and Pythagorean fuzzy sets, q-rung orthopair fuzzy sets provide decision makers more flexible space in expressing their opinions. Preference relations have received widespread acceptance as an efficient tool in representing decision makers’ preference over alternatives in the decision-making process. In this paper, some new preference relations are investigated based on the q-rung orthopair fuzzy sets. First, a novel score function is presented for ranking q-rung orthopair fuzzy numbers. Second, q-rung orthopair fuzzy preference relation, consistent q-rung orthopair fuzzy preference relation, incomplete q-rung orthopair fuzzy preference relation, consistent incomplete q-rung orthopair fuzzy preference relation, and acceptable incomplete q-rung orthopair fuzzy preference relation are defined. In the end, based on the new score function and these preference relations, some algorithms are constructed for ranking and selection of the decision-making alternatives.