The ability of large language models to solve complex mathematical problems has progressed significantly, particularly for tasks requiring advanced reasoning. However, the scarcity of sufficiently challenging problems, particularly at the Olympiad level, hinders further advancements. In this work, we introduce PromptCoT, a novel approach for automatically generating high-quality Olympiad-level math problems. The proposed method synthesizes complex problems based on mathematical concepts and the rationale behind problem construction, emulating the thought processes of experienced problem designers. We provide a theoretical analysis demonstrating that an optimal rationale should maximize both the likelihood of rationale generation given the associated concepts and the likelihood of problem generation conditioned on both the rationale and the concepts. Our method is evaluated on standard benchmarks including GSM8K, MATH-500, and AIME2024, where it consistently outperforms existing problem generation methods. Furthermore, we demonstrate that PromptCoT exhibits superior data scalability, consistently maintaining high performance as the dataset size increases, outperforming the baselines. The implementation is available at https://github.com/zhaoxlpku/PromptCoT.