Currently, there are many ways of approaching the complexity of issues related to public health. One of these is the relationship between humans and the environment, specifically through environmental health indicators. Thus, this study aims to propose a methodology based on indicators of environmental health and multi-criteria analysis in order to analyze the health situation in cities, allowing environmental data to be compared between municipalities comprising the region of the upper course of the Paraíba river. To this end, archival and exploratory research and multi-criteria analysis was used. The municipality of São Domingos do Cariri had the lowest Multi-criteria Environmental Health indicator, followed by the cities of Amparo, Zabelê, São João do Tigre, Congo, Coxixola, São Sebastião do Umbuzeiro, Barra de São Miguel, Cabaceiras, Camalaú, Ouro Velho and São João do Cariri, as these municipalities had negative MEHI , in other words, they need better public management strategies in order to improve this scenario. The best performing cities, with positive MEHI were: Monteiro, Boqueirão, Sumé, Serra Branca and Prata.