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This study presents a novel combination of multistage adaptive testing with multidimensional testlet response model (MTRM) (testlet-based M-MST). An MTRM was proposed as the foundation for analyzing data before designing testlet-based M-MST. Then, we proposed two types of automated test assembly algorithms and one set of routing rules that can facilitate the development of testlet-based M-MST. Testlet-based M-MST designs were evaluated through simulated and real studies. Besides, a testlet-based multidimensional computerized adaptive testing (MCAT) was simulated as a baseline design to demonstrate the advantage of testlet-based M-MST. Results indicate that the proposed MTRM has good recovery; the proposed algorithms generate testlet-based M-MST with good-quality control and better recovery than testlet-based MCAT; the proposed MTRM outperformed multidimensional item response theory model.