Introduction Moral dilemmas are a common tool in moral decision-making research. However, they are often hardly comparable across languages and cultures. Here, we propose a methodology to adapt, convert and test moral dilemmas in languages different from English, by outlining the process followed for the creation of the comprehensive 4CONFiDe set. Methods To evaluate cultural effects, English and Italian versions of the 4CONFiDe were evaluated by English-native speakers proficient in Italian, and Italian-native speakers proficient in English (Study 1). To assess the contribution of the four conceptual factors used by Christensen et al. to the levels of arousal, valence and familiarity experienced with each dilemma, an independent group of Italian native speakers (n = 112) completed the 4CONFiDe set (Study 2). Results Both linear mixed models and Bayesian statistics confirmed that moral choices were made irrespective of participants', native language and dilemmas' version, suggesting that the translation was culturally-representative. Moreover, they showed that the proposed dilemmas were perceived by participants with different degrees of arousal, pleasantness and familiarity based on some of the conceptual factors and that three of the four conceptual factors (Personal force, Intentionality and Evitability) determined participants' moral choices. Conclusions Standardized, culturally-equivalent moral dilemmas provide researchers with a tool that allows further developments of the field.