Sarcopenic obesity SO is a complex condition characterized by the coexistence of sarcopenia and obesity commonly seen in older adults and individuals with chronic diseases including malignancies. SO is associated with a markedly increased risk of poor clinical outcomes including diminished quality of life reduced physical function and elevated mortality. Accurate diagnosis and effective management are essential to mitigating these risks and improving patient outcomes. Based on current research and clinical experience this paper uses the GRADE system Grading of Recommendations Assessment Development and Evaluation to grade the evidence quality and recommendation strength of recommendations related to SO clinical screening diagnosis evaluation and treatment to form a consensus. The guidelines advocate for a stepwise diagnostic approach integrating assessments of skeletal muscle function and body composition and the specific diagnostic thresholds for the China population should be used to ensure the accuracy of diagnosis. Treatment recommendations encompass pharmacological therapies nutritional interventions and exercise programs and these interventions should be individually adjusted according to the patient's specific needs and condition. These guidelines aim to equip clinicians with a standardized framework to optimize the management of SO and enhance patient care.