The sustainable development of a river basin depends on the supply of ecosystem services in the river basin"s water ecosystem. Therefore, the health of river water ecosystems is an important guarantee. Taking the Weihe River Basin as the research area, this paper sorts out relevant domestic and foreign data and research results in 2004-2024 through bibliometrics, and deeply explores the water quality, habitat quality, biodiversity, and water ecology health of the Weihe River Basin. It summarizes the selection of water ecological health assessment indicators in the Weihe River Basin, clarifies the advantages, disadvantages, and applicable scopes of different water ecological health assessment methods. Based on these, we summarize the evolution law of water ecological health in the Weihe River Basin during 2004-2024. Overall, the water quality of the Weihe River has improved. The diversity of plankton and periphytic algae showed a downward trend in a certain period, but has shown a recovery trend in recent years. Water pollution and habitat destruction are the main factors threatening the water ecological health of the Weihe River Basin, especially the middle and lower reaches still have serious pollution problems. On this basis, combined with the ecological protection policies and regulations of the Weihe River Basin, the importance of water ecological environment management to water ecological health is evaluated. Finally, combined with the "Hanjiang-to-Weihe Water Transfer Project", the impact of increased water resources in the Weihe River Basin on water ecological health is prospected.