Abstract: The monitoring data is a direct response of the working condition of the sluices. However, the current sluice safety evaluation methods based on engineering reliability and safety appraisal specifications have the limitation of not making full use of the safety monitoring data. The development of the sluice health diagnosis system based on the safety monitoring is thus of great practical importance. On the basis of the sluice safety monitoring and the analysis of the sluice failure mechanism, the research on setting of the sluice health diagnosis indexes based on the safety monitoring is carried out in this study. And then, a general multi-level and multi-index health diagnosis index system for sluices is developed; and a four-grade (normal, basically normal, abnormal, and severely abnormal) classification scheme, and the corresponding evaluation set and membership degree range have been designed. Thus, a novel health diagnosis system for the sluices is established based on the safety monitoring. A practical engineering example, the Dongxi sluice of the Chaozhou water supply works, is analyzed by the proposed method. The research and analysis results show that the sluice health diagnosis system given by this paper based on the safety monitoring can accurately reflect the actual health status of the sluice, which can provide a basic condition and technical support for the real-time online safety monitoring of the sluices.