Abstract: Health assessment on small and medium-sized rivers serves as an effective means to quantify the ecological health status of river systems, but there remains a lack of unified evaluation criteria.To objectively assess the health status of small and medium-sized rivers, this study takes six rivers in the Qingfengshanxi River Basin of Fengcheng City, Jiangxi Province, as a case study.A comprehensive evaluation index system was established, encompassing three aspects: water environment, aquatic ecology, and social service functions, with a total of 10 indicators.A hybrid weighting method combining the Delphi method and entropy weight method was utilized to determine the weights of each indicator, and a comprehensive evaluation model was applied for assessment.The results showed that the Shijiang River attained the highest total score of 87.81 points, achieving an ideal health status.The health status of the remaining rivers all reached a healthy level, indicating that although their functions were partially impaired, the overall system remained in a sustainably healthy state.This study provides a scientific basis for ecological health assessments of small and medium-sized rivers.