Abstract: As an important historical and cultural heritage, traditional villages are the living carriers of Chinese civilization and constitute a dynamic cultural ecosystem entity. Currently, China places great emphasis on the protection and inheritance of traditional villages. However, external disturbances such as rapid urbanization and modernization have brought about numerous changes, resulting in an imbalance in the cultural ecosystem of some traditional villages. The protection and development of traditional villages thus face multiple contradictions and practical dilemmas. In order to assess the health status of the traditional village cultural ecosystem and identify its prominent issues, this paper constructs a health evaluation index system for the traditional village cultural ecosystem based on the‘Pressure-State-Response’(PSR) evaluation model. This paper utilizes the composite index method to measure and classify the overall health status of the traditional village cultural ecosystem into different health levels. By analyzing the health characteristics from the multidimensional perspectives of pressure, state, and response, this paper focuses on key issues and propose a path for the living conservation and sustainable development of traditional villages in conjunction with practical experience. Furthermore, this paper conducts an empirical analysis using twelve traditional Chinese villages in Mentougou District of Beijing as samples. This study explores the theoretical basis for the modernization and transformation of traditional villages from a cultural and ecological perspective, aiming to provide a reference for the sustainable development of traditional villages and the construction of harmonious and beautiful rural areas.