Abstract: The rapid development of suborbital commercial spaceflight has gradually transformed space tourism from a conceptual vision into tangible reality, presenting entirely new challenges for medical screening of ordinary passengers. Suborbital flight involves unique environmental factors including hypergravity exposure (typically 3-6 G), brief microgravity exposure, and significant psychological stress. Existing aviation medical fitness certification systems were primarily designed for conventional air transport environments and are insufficient to cover the acute exposure characteristics of suborbital flight. Meanwhile, professional astronaut selection models exhibit substantial internal heterogeneity: spaceflight pilots are selected from an extremely small pool of specialists under exceptionally stringent criteria; payload specialists, though subject to relatively lower requirements, still require systematic adaptive training and serve mission-oriented medical objectives—both fundamentally distinct from recreational passengers seeking experiential travel. Chinese populations possess unique characteristics in constitutional traits, disease spectrum distribution, and health literacy; direct application of foreign standards or professional astronaut criteria is inherently inadequate in applicability. There is an urgent need to establish an evidence-based, risk-stratified screening consensus tailored to Chinese populations. This consensus was developed by a working group comprising 43 experts from 21 disciplines: space medicine, emergency and critical care medicine, cardiovascular medicine, respiratory medicine, neurology, psychiatry and psychology, geriatrics, endocrinology and metabolism, rheumatology and immunology, hematology, oncology, gastroenterology, orthopedics, urology, obstetrics and gynecology, ophthalmology, otorhinolaryngology–head and neck surgery, stomatology, dermatology, nuclear medicine, and public health. The group systematically reviewed relevant domestic and international standards and literature (January 2006 to January 2026), employed a modified Delphi method through two rounds of expert voting, and formulated 60 recommendations graded according to the GRADE framework. These recommendations encompass general health status, system-specific disease screening, ancillary examinations, pre-flight adaptive training, and special population management. This consensus innovatively introduces the concepts of "functional reserve" (the physiological and psychological functional potential required for passengers to maintain flight safety) and "environmental stress matching" (dynamic adaptation of individual functional reserve to specific mission environmental stressors), establishing a three-tier risk stratification model and the "Space Passenger Functional Reserve Assessment System (SP-FRAS)" which covers five dimensions—cardiovascular, neuro-vestibular, psychological-cognitive, musculoskeletal, and metabolic-nutritional—along with monitoring priorities across three stages: screening criteria, in-flight maintenance, and post-flight recovery. The consensus also specifies mandatory training items such as centrifuge high-G tolerance training and emergency response training, as well as recommended items such as parabolic flight microgravity experience, with detailed requirements for phased training programs and training institution qualifications. This consensus aims to provide an exploratory and operational reference for the formulation of safety standards and health risk assessment for suborbital space tourism in China; subsequent validation and iterative refinement in clinical practice remain essential.