Background The radiation accident emergency drill is an important way to maintain and improve the response ability of emergency organizations, but at present, the evaluation of the drill is mainly based on the qualitative evaluation of the surface performance of the key links, there is not yet a systematic, full-flow, accurate and targeted evaluation method of exercises. Purpose This study aims to improve the quality and real-time evaluation of radiation accident emergency drill. Methods Firstly, the alternative evaluation indicators were summarized on the basis of literature survey. The method of expert investigation was used to check the alternative indexes and establish the evaluation index system. Then, the analytic hierarchy process (AHP) method was applied to the calculation of weight distribution, and the fuzzy comprehensive evaluation (FCE) was employed to build comprehensive evaluation model for radiation accident emergency exercises. Finally, based on the AHP-PCE, comprehensive scores of the evaluation indexes at all levels of three typical examples were calculated. Results The FCE-based model synthesizes the stage of the drill preparation, the drill implementation and the drill summary, and forms the general goal of the radiation accident emergency drill effect. The evaluation system of radiation accident emergency maneuver is set up with 5 first-level indexes and 15 s-level indexes to realize the comprehensive evaluation of the radiation accident emergency drill. Conclusions The example verification shows that the AHP-FCE model has a good adaptability and rationality, and has a good application value in the evaluation of radiation accident emergency drill.