OBJECTIVE : Short-term medical service trips (MSTs) are a controversial modality for addressing the health of marginalized populations. Despite their prevalence, there are no routinely used evaluative frameworks. This study used stakeholder consensus to validate a literature-based framework for MST best practices. METHODS : A recent systematic review was used to construct a preliminary list of best practices for short-term MSTs. We then recruited a multidisciplinary panel of academics, medical professionals, program coordinators, and non-medical volunteers for a three-round e-Delphi consensus-building exercise to review the list. A 7-point Likert scale was used, with mean scores 4-7 representing rejection, scores < 2 representing acceptance, and elements scoring in between being redistributed for discussion. RESULTS : The literature review identified 30 best practices. Twenty-six stakeholders were recruited for the e-Delphi panel, with 73.1% responding to all three rounds. Eighteen elements were accepted into the final framework. CONCLUSIONS : This framework identifies essential MST best practices and enables volunteers to compare organizations. Future research should translate this framework into an assessment tool and initiate dialogue between host communities, local clinicians, and sending organizations.