Abstract: Water-network regions are distinctive landscapes where wetlands are densely distributed in a reticular pattern. Within these regions, small and micro wetlands are numerous and widespread, and their ecological health plays a critical role in sustaining the broader wetland ecosystem.To assess this health, we developed a rapid evaluation system tailored to the characteristics of water-network regions. The framework includes two dimensions (wetland attributes and surrounding land use), measured by eight indicators: area suitability, patch complexity, patch aggregation, density of built-up land, farmland, forest, grassland, and water bodies. Using Suzhou City as a case study, we applied a combined AHP-entropy weighting method and the TOPSIS model to evaluate the ecological health of 167 471 small and micro wetlands in 2021.The results show that the average health index of Suzhou’s small and micro wetlands was 0.2173, corresponding to a “moderate” rating. By area, wetlands were distributed across five health categories as follows: excellent (10.21%), good (26.13%), fair (34.66%), poor (20.14%), and very poor (8.87%). Spatially, ecological health followed a pattern of “low in the urban core, moderate in the surrounding areas, and locally high in specific zones.” Among the districts, Kunshan had the overall highest ecological health.Based on these findings, we recommend prioritizing ecological restoration in key wetlands, conducting regular health assessments, and strengthening related policies and regulations to enhance the long-term sustainability of Suzhou’s small and micro wetlands.