[Objective] The health level of the Jinshui River in Zhengzhou City was evaluated by using the concept of resilience in order to provide a theory basis for the restoration and scientific management of the Jinshui River. [Methods] Based on a pressure-state-response model (PSR), an urban river health evaluation index system was constructed for the Jinshui River in Zhengzhou City. The combined weighting method and a matter-element extension model were used to evaluate river health and to forecast development trends. An urbanization-river health response model was constructed to analyze the impact of urbanization on urban river health. [Results] The river health levels in the study area showed obvious spatial variability, and the health levels of reaches 1, 3, 6, 7, 8, 11, and 14 were healthy, sub-illness, sub-illness, illness, sub-healthy, sub-illness, and healthy (the reach number increased from the estuary to the upstream positions). The health levels of the river reaches that were located in the new urban area were higher than those located in the old urban area. The health level of reaches 1, 3, 8, and 14 had a tendency for further deterioration, while the health levels of reaches 6, 7, and 11 had a tendency for further improvement. The threshold for the level of urbanization (impervious area ratio in urban watersheds, ISC) that would have a significant effect on river health was around 50%. [Conclusion] There were obvious spatial differences in the health level of each river section in the study area due to the influence of the surrounding urban environment. The health of urban rivers was closely related to the level of urbanization. Therefore, urban planning research should be strengthened to protect and restore urban rivers, thereby promoting water-city integration.