Abstract: High-voltage cables are a primary medium for power transmission, and their health status directly affects the reliability of power supply. Therefore, research on health assessment methods and subsequent operation and maintenance strategies for high-voltage cables is of great significance. Traditional operation and maintenance models suffer from issues such as numerous inspection blind spots, low efficiency, and poor accuracy. Leveraging the new-generation equipment asset lean management system, this study establishes a health assessment system for high-voltage cables. It comprehensively evaluates transmission lines from three key aspects: equipment status, environmental factors, and insulation aging, and formulates corresponding differentiated operation and maintenance strategies. This approach enables lean operation and maintenance of lines and equipment. Field implementation and application demonstrate the feasibility and effectiveness of the proposed strategy, providing valuable insights for health assessment and precise operation and maintenance of high-voltage cables.