Abstract: The Asia-Pacific Economic Cooperation (APEC) is one of the influential intergovernmental multilateral cooperation organizations in the Asia-Pacific region. In recent years, it has increasingly prioritized health cooperation, establishing operational mechanisms such as the Health Working Group. In 2026, China will host the APEC meetings, presenting a critical opportunity to deepen health cooperation under the APEC framework and enhance China′s influence, which warrants thorough exploration. This study systematically reviews 239 official publicly available documents and project materials published from 1997 to 2024 to analyze the current state, priority topics, and trends in health governance within the APEC framework. Furthermore, it examines China’s progress, challenges, and reflections and recommendations regarding its participation in APEC health cooperation, aiming to provide a scientific reference for China to deepen health collaboration under this framework in the future.