Assessing the health and security of natural ecosystems is unavoidable to regulate and manage deterioration and prioritize management and conservation activities. As a result, the current study was conducted to assess the health and ecological security of the Galazchai Watershed in Oshnavieh Township, West Azerbaijan Province, Iran, utilizing criteria linked to various hydrologic, anthropogenic, and climatic aspects. In the conceptual pressure–state–response (PSR) method, 26 criteria with acceptable variance inflation factor and Durbin–Watson statistics were chosen. The Galazchai Watershed's ecology's health and security status and spatial differences were also chosen and analyzed at 17 subwatersheds. The contributions of the pressure (P), status (S), and reaction (R) indices to the watershed health index were 38.3, 30.1, and 31.6%, respectively, according to the findings. The health index for the watershed ranged from 0.388 to 0.688. Almost 64% of the watershed's area was in relatively healthy conditions. Additionally, the maximum and the minimum values of the ecological security index were 0.608 and 0.236, allocating 58% of the area to moderate ecological security. The northern part of the watershed had healthier and moderately desirable ecological security than the southern part, with unhealthy and relatively undesirable conditions. In this sense, the main problems of the study area were primarily related to anthropogenic factors followed by hydrologic ones. The procedure used in the current study based on health and ecological security status can be applied as a practical guideline by local managers for efficient and adaptive watershed management.