Abstract: Ancient trees, often regarded as green national treasures, represent irreplaceable resources for studies of tree physiology and for the preservation of biodiversity and ecosystem stability. To evaluate the health risks associated with ancient tree resources, a comprehensive health risk assessment model was developed consisting of four criterion layers (tree structure, root and root collar, surrounding environment, and anthropogenic disturbance) and 21 specific evaluation indices, including trunk inclination, root damage, and pest and disease occurrence. Analytic hierarchy process (AHP) was applied to quantify weights for all criterion layers and indicators. Model performance and practical validity were examined through a year-long, quarterly field survey of 100 ancient trees in Fuzhou City. Weight analysis indicated that pavement burial (0.125 8), root damage (0.090 7), and pests and diseases (0.083 0) represented the most influential risk factors. Pavement burial emerged as the dominant threat to tree health and was observed in 25% of surveyed cases, primarily involving cement hardening of tree pits and infilling of root zones with construction waste. Pests and diseases accounted for 24% of cases, with termites, red spiders, powdery mildew, and root rot frequently detected, while root system damage was recorded in 15% of cases. Clear seasonal effects were observed, with insect activity peaking during spring leaf emergence and fungal diseases impacted by high temperature and humidity conditions in summer. Field validation demonstrated strong feasibility and applicability of the proposed assessment framework. This empirically tested model provides a practical technical system for scientific management of ancient tree health and supports evidence-based conservation strategies. Effective daily management should prioritize protection of tree bases, root collars, and root systems to mitigate dominant health risks and enhance long-term survival of ancient tree resources.