Abstract: At present, urban physical examination in China is mainly carried out in big cities and above. In view of the differences between small cities and big cities in the development basis, development mode, and development problems, it is necessary to explore a set of urban physical examination assessment methods suitable for the majority of small cities. Taking the urban physical examination in 2022 in Mengzi, Yunnan Province as an example, this paper proposes that the urban physical examination work in small cities should promote the majority of small cities to assume the three functions of 'ecological livability' 'basic services' and 'characteristic development' as the important goal, respect the basis of physical examination work in small cities, and adopt the 'customized' thinking. Focusing on the three key links of 'grasping the foundation', 'consulting public opinion', and 'enhancing characteristics', an 'accurate' and 'economic' normal technical path of urban physical examination work is explored.