The evaluation for ecosystem health is one of the hotspots within the fields of macro ecology and ecosystem management. Conducting analysis at the regional scale is an important direction for evaluating ecosystem health. Changing the spatial scale from the local to the regional level leads to great differences in the targets and methodologies for evaluating ecosystem health and creates a new direction for regional ecosystem health research. Compared to ecosystem health at the local scale, which refers to a single ecosystem type, regional ecosystem health focuses on the health conditions and spatial patterns of different ecosystem types. However, there is little attention to this very research. Based on the progress on ecosystem health research at the regional scale, the study reported in this paper aims to discuss the implications of the concept of regional ecosystem health and to put forward a methodology for evaluating regional ecosystem health. The main results are as follows: (1) there is a significant scaling effect on the ecosystem health analysis and the regional level is the key scale used to focus on the correlation between spatially neighboring ecosystems in terms of ecosystem health; (2) regional ecosystem health can be defined through these four aspects, i.e. vigor, organization, resilience, and ecosystem service function; (3) the basic object of the evaluation for regional ecosystem health is spatial entity, which is the matrix of different ecosystem types; (4) the index system method is the only approach for evaluating regional ecosystem health; (5) the absolute thresholds of the evaluation indices for regional ecosystem health do not exist; the aim of the evaluation is to discuss the temporal change and spatial differences of health conditions and not to ascertain whether a region is healthy or not in the view of ecological sustainability; and (6) the integration of results from the evaluation at multi-spatial scales, the application of this methodology to landscape ecology, and the utilization of geographic information systems (GIS), remote sensing (RS), and Global Positioning Systems (GPS) technologies are the main directions for further research.