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The health status of Quaternary red soil is a comprehensive reflection of the production and ecological service functions, which directly affects agricultural productivity and ecosystem sustainability. Based on the Cornell Soil Health Assessment (CASH) system frame, a health evaluation system for Quaternary red soils was established including the soil's physical, chemical, and biological indicators. The soil's health status under different land use patterns (the buried Quaternary red soil, sparse forest and grassland, grassland, woodland, and arable land) was systematically diagnosed in the low hilly region of western Liaoning Province. The results showed significant differences in the soil health comprehensive index of the Quaternary red soils under different land use patterns (the whole soil), presenting a trend of woodland (0.64) > arable land (0.61) > grassland (0.49) > sparse forest and grassland (0.37) > buried Quaternary red soils (0.33). The woodland and arable land are at a healthy level, the grassland and sparse forest and grassland are at a sub-healthy level, and the buried Quaternary red soil is at an unhealthy level. The health status of the topsoil layer (A) under different land use patterns has a trend of woodland (0.86) > arable land (0.73) > grassland (0.70) > sparse forest and grassland (0.67). This is consistent with the overall health status of the profile, better than that of subsoil layer (B), which presents a trend of arable land (0.41) > grassland (0.40) > woodland (0.38) > sparse forest and grassland (0.34), with relatively poor soil health conditions. Overall, the soil health status of the four land use patterns is better than that of the buried Quaternary red soils, showing an evolution trend towards healthy soil. This indicates that at this stage, human land use activities have to some extent promoted the healthy development of Quaternary red soils. The Quaternary red soils of the woodland have a healthy status, and the land use pattern is suitable and can be scientifically recommended in low mountain and hilly areas. [ABSTRACT FROM AUTHOR]