Abstract: As China's urbanization rate surpasses 65%, the issue of "emphasizing construction and neglecting management" in municipal road and bridge projects has become increasingly prominent. Traditional management models struggle to address facility aging and safety risks. The city health check system, as a novel urban governance tool in China, provides an innovative approach for the whole-life-cycle management of municipal infrastructure. However, it has not yet been systematically applied in the field of municipal road and bridge engineering. Based on policy evolution and practical needs, this paper explores the deep integration of city health checks with municipal road and bridge engineering, aiming to address structural contradictions such as cross-departmental data barriers, gaps in standard implementation, and insufficient funding guarantees. The study proposes a "3E" graded evaluation model, combining the road and bridge structural health monitoring index system with city health checks to construct a scientific infrastructure health evaluation index system. It achieves precise decision-making driven by data through a three-dimensional monitoring system of "air-space-ground-network-virtual-actual" and intelligent diagnosis technology. In terms of management mechanisms, an innovative collaborative governance framework is proposed, encompassing digital twin modeling, risk assessment and early warning, and intelligent decision support systems, promoting the transformation of engineering management from empirical judgment to scientific diagnosis. At the policy level, it is suggested to improve the whole-life-cycle management legislative system, establish flexible and dynamic technical standards and norms, and ensure the sustainable implementation of city health checks through a safeguard mechanism combining fiscal incentives and market regulation. The research results show that city health checks can significantly enhance the governance efficiency of municipal road and bridge projects, providing theoretical support and practical paths for digital management of infrastructure and the construction of resilient cities.