diff --git a/docs/hooks/problem-list-item-create.md b/docs/hooks/problem-list-item-create.md
new file mode 100644
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+# `problem-list-item-create`
+
+| Metadata | Value
+| ---- | ----
+| specificationVersion | 1.0
+| hookVersion | 0.1.0
+| hookMaturity | [1 - Submitted](../../specification/current/#hook-maturity-model)
+
+## Workflow
+
+The `problem-list-item-create` hook fires once a clinician has added one or more new problems to a patient's problem list. 
+This hook may fire with one or more newly added conditions of category `problem-list-item` that are newly finalized. 
+The context of the hook includes these new conditions. Note that this hook occurs once the new problem(s) is finalized; thereby enabling the CDS Service to recommend actions related to the problem in lieu of suggesting modifications to the newly created problem. 
+
+## Context
+
+Field | Optionality | Prefetch Token | Type | Description
+----- | -------- | ---- | ---- | ----
+`userId` | REQUIRED | Yes | *string* | The id of the current user.<br />For this hook, the user is expected to be of type [Practitioner](https://www.hl7.org/fhir/practitioner.html) or [PractitionerRole](https://www.hl7.org/fhir/practitioner.html).<br />For example, PractitionerRole/123 or Practitioner/abc.
+`patientId` | REQUIRED | Yes | *string* |  The FHIR `Patient.id` of the current patient in context
+`encounterId` | OPTIONAL | Yes | *string* |  The FHIR `Encounter.id` of the current encounter in context
+`conditions` | REQUIRED | No | *object* | DSTU2 - FHIR Bundle of Conditions where `category` is `problem-list-item`<br/> STU3 - FHIR Bundle of Conditions where `category` is `problem-list-item`<br/> R4 - FHIR Bundle of Conditions where `category` is `problem-list-item`
+
+### Example (R4)
+
+```json
+{
+  "context": {
+    "userId": "Practitioner/123",
+    "patientId": "1288992",
+    "encounterId": "89284",
+    "conditions": {
+      "resourceType": "Bundle",
+      "entry": [
+        {
+          "resource": {
+            "resourceType": "Condition",
+            "id": "3a14127f",
+            "category": "problem-list-item",
+            "clinicalStatus": {
+              "coding": [
+                {
+                  "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
+                  "code": "active"
+                }
+              ]
+            },
+            "verificationStatus": {
+              "coding": [
+                {
+                  "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
+                  "code": "confirmed"
+                }
+              ]
+            },
+            "code": {
+              "coding": [
+                {
+                  "system": "http://snomed.info/sct",
+                  "code": "16114001",
+                  "display": "Fracture of ankle"
+                }
+              ],
+              "text": "Fracture of ankle"
+            },
+            "subject": {
+              "reference": "Patient/1288992"
+            },
+            "onsetDateTime": "2018-10-15T04:13:17-04:00",
+            "assertedDate": "2018-11-15"
+          }
+        }
+      ]
+    }
+  }
+}
+```
+
+### Example (STU3)
+
+```json
+{
+   "context":{
+      "userId":"Practitioner/123",
+      "patientId":"1288992",
+      "encounterId":"89284",
+      "conditions":{
+         "resourceType":"Bundle",
+         "entry":[
+            {
+               "resource":{
+                  "resourceType":"Condition",
+                  "id":"3a14127f",
+                  "category":"problem-list-item",                 
+                  "clinicalStatus":"active",
+                  "verificationStatus":"confirmed",
+                  "code":{
+                     "coding":[
+                        {
+                           "system":"http://snomed.info/sct",
+                           "code":"16114001",
+                           "display":"Fracture of ankle"
+                        }
+                     ],
+                     "text":"Fracture of ankle"
+                  },
+                  "subject":{
+                     "reference":"Patient/1288992"
+                  },
+                  "onsetDateTime":"2018-10-15T04:13:17-04:00",
+                  "assertedDate":"2018-11-15"
+               }
+            }
+         ]
+      }
+   }
+}
+```
+
+### Example (DSTU2)
+
+```json
+{
+  "context": {
+    "userId": "Practitioner/123",
+    "patientId": "1288992",
+    "encounterId": "89284",
+    "conditions": {
+      "resourceType": "Bundle",
+      "entry": [
+        {
+          "resource": {
+            "resourceType": "Condition",
+            "id": "smart-Condition-548",
+            "category": {
+              "text": "Problem",
+              "coding": [
+                {
+                  "system": "http://argonautwiki.hl7.org/extension-codes",
+                  "code": "problem",
+                  "display": "Problem"
+                }
+              ]
+            },
+            "text": {
+              "status": "generated",
+              "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Vitamin D deficiency</div>"
+            },
+            "patient": {
+              "reference": "Patient/1288992"
+            },
+            "code": {
+              "coding": [
+                {
+                  "system": "http://snomed.info/sct",
+                  "code": "34713006",
+                  "display": "Vitamin D deficiency"
+                }
+              ],
+              "text": "Vitamin D deficiency"
+            },
+            "clinicalStatus": "active",
+            "verificationStatus": "confirmed",
+            "onsetDateTime": "2018-11-15"
+          }
+        }
+      ]
+    }
+  }
+}
+```
+
+## Change Log
+
+Version | Description
+---- | ----
+0.1.0 | Initial Release
diff --git a/mkdocs.yml b/mkdocs.yml
index 2096acd3..03dfe897 100644
--- a/mkdocs.yml
+++ b/mkdocs.yml
@@ -28,6 +28,7 @@ nav:
     - 'encounter-start 1' : 'hooks/encounter-start.md'
     - 'encounter-discharge 1' : 'hooks/encounter-discharge.md'
     - 'medication-refill 1' : 'hooks/medication-refill.md'
+    - 'problem-list-item-create 1' : 'hooks/problem-list-item-create.md'
 - Quick Start: 'quickstart.md'
 - Cheat Sheet: 'cheat-sheet/Cheat Sheet - Sept 2019.pdf'
 - Best Practices: 'best-practices.md'