Abstract: Environmental health risk assessment is an important tool for making risk management decisions and achieving environmental and public health goals through actionable measures. This article systematically reviews the evolution of environmental health risk assessment and risk management internationally, including legal authorization to regulate various forms of pollution for the protection of the environment and public health; institutional arrangements for risk assessment and risk management, focusing on risk management requirements, maximizing the practicality of risk assessment, and effectively guiding the decision-making; and continuously summarizing practical experiences while dynamically updating the technical system for environmental health risk assessment. The most important lesson is that system development must align with practical conditions, resulting in a set of sound and effective systems. There are commendable practices in the construction of the system, primarily reflected in legal authorization that provides scientific assessment and regulatory guarantee, enabling full and effective implementation of the system, and guiding decision-making with the best scientific method and evidence. To address the environmental health challenges faced by China and implement the strategies for building a beautiful and healthy China, suggestions for promoting the construction of the environmental health risk assessment system in accordance with China's national conditions have been proposed.