Abstract: Clarifying the level of ecosystem health is widely recognized as the foundation for promoting regional protective management. However, a comprehensive quantitative assessment specifically targeting the health status of coastal wetlands remains lacking. Conventional evaluation methods not only are limited in their ability to objectively reveal wetland ecosystem health but also fail to establish an effective linkage between ecosystem service evaluation and regional natural health assessment. In this study, the vigor-organization-resilience-ecosystem service (VORS) model was adopted and systematically improved by incorporating the unique characteristics of coastal wetlands, including water environment, species richness, and important landscape connectivity. Six typical coastal wetlands in Hebei Province were selected, and their ecosystem health levels were evaluated via the modified model. The results showed that the ecosystem health index of the six typical coastal wetlands in Hebei Province ranged from 0.50 to 0.64, and the area classified as healthy wetlands accounted for 93.47% of the total area of the six wetlands, indicating a dominant role of healthy wetlands. The health of the wetlands was primarily influenced by wetland type. From the four health assessment indicators, the vigor status of the six typical coastal wetlands was uneven in space, with significantly different water quality and soil conditions and low vegetation coverage. The organization differentiation was obvious, with the index span of 0.43. The resilience index showed the best performance (0.65–0.72), with small spatial differences. The total value of ecosystem services reached 3.006×10⁹ ¥, in which the value of hydrological regulation services accounted for 49.53%. On the basis of the modified VORS model, a health assessment framework specifically suitable for wetland ecosystems was constructed. This framework effectively addressed the major limitations — unclear criteria and susceptibility to subjective interference — of previous coastal wetland health evaluation systems, thereby offering new insights and methodological advances for ecosystem health assessment. The improvements made in this study, especially the integration of wetland-specific indicators into the VORS model, enhanced the objectivity and comparability of the assessment results. Furthermore, the findings provide practical references for the conservation and management of coastal wetlands in Hebei Province. It is recommended that regular monitoring of vigor indicators be conducted to enable early detection of ecosystem degradation, and priority should be given to landscape-level restoration measures in areas with low health indices. In addition, strengthening the hydrological regulation function of coastal wetlands is suggested as a nature-based solution for regional water security. Overall, this study contributes to the coordinated achievement of ecological and socio-economic objectives in the Hebei coastal region.