Abstract: Data resources and assessment frameworks are key requirements for ecosystem health assessment. High-precision land-use survey data ensuring the accuracy of results is introduced in this paper. In terms of assessment frameworks, the Pressure-State-Response (PSR) model can incorporate both the influence of human factors and the response of the environment. Under the PSR framework, a Vigor-Organization-Resilience-Service (VORE) assessment index system is developed to diagnose the regional land ecosystem health in Pinggu District of Beijing. The same-sized grids that present land ecosystem health on a diminutive scale was used as the assessment unit. Spatial distribution characteristics of land ecosystem health were analyzed using spatial autocorrelation. The conclusions are as follows: more than 70% of the total area had a health condition equal to or better than Level III. A slight decline in ecosystem health condition occurred between 1993 and 2011; the average value of ecosystem health condition was 0.59 in 1993 and 0.57 in 2011. In general, ecosystem health within Pinggu District was good. Urbanization and industrialization processes have led to the deterioration of land ecosystem health in the central urban area. In the central hilly areas, the nature reserves have helped to improve the local land ecosystem health condition. In addition, the increase in environmental management investment has improved land ecosystem health condition in the southern plains. There is still considerable spatial heterogeneity in land ecosystem health throughout the region. The paper concludes that the ecosystem health condition in the hilly and mountainous areas is superior to that in plain areas. Global Moran’s I was 0.49 in 1993, and increased to 0.61 in 2011. Greater spatial agglomeration resulted in an increase in the Global Moran’s I. In plain areas, Global Moran’s I for ecosystem health condition increased from 0.42 in 1993 to 0.46 in 2011. In hilly and mountainous areas, Global Moran’s I for ecosystem health condition increased from 0.41in 1993 to 0.46 in 2011. The results indicate that the ecosystem health condition in plain areas is declining, and that of hilly and mountainous areas has markedly improved. Human factors play a critical role in land ecosystem health. In plain areas, human influence leads to the replacement of natural and semi-natural landscapes with highly modified landscapes. Nevertheless, human factors have also made major contribution to the natural landscape in the hilly and mountainous areas near the Sizuolou region through the construction of a natural conservation area. As the emergency water sources and ecological conservation areas, Pinggu District should put emphasis on three key regions to improve its ecological condition. It is essential to maintain ecosystem health near Sizuolou region. Through the construction of ecological corridors, the “isolated island” effect of the reserves can be avoided. As for the hilly and mountainous areas where land ecosystem conditions become worse, the paper recommends to make full use of its resources advantage to coordinate the economic development and the ecological construction. The expansion of the central urban area in Pinggu District should be limited to alleviate the pressure of the land ecosystem. Ecological land consolidation in the central areas is necessary to achieve the goal of sustainable development.