Abstract: Environmental health risk assessment (EHRA) serves as a key scientific foundation for developing and revising air quality guidelines and standards(AQGs/AQSs). This review systematically outlines the EHRA framework and methodologies, with a focus on its specific applications in the development and updating of AQGs/AQSs. A comparative analysis is conducted between typical international practices and the current situation in China. The results indicate that international practices have deeply integrated EHRA into the standard development and revision process. While China has achieved notable progress in exposure assessment, hazard identification, and dose-response modeling, EHRA remains insufficiently integrated into the policy decision-making process for establishing and revising standards. This has led to an inadequate translation of scientific evidence into policy and a lack of guidelines and standards based on localized scientific evidence, which has become a key bottleneck restricting the refinement of air quality management and the maximization of health benefits in China. Future efforts should focus on establishing and improving the mechanism for translating risk assessment results into policy. Breakthroughs should also be pursued in EHRA methodologies. Key areas requiring technical breakthroughs include developing region-specific standards, enhancing high-precision exposure assessment, quantifying the combined health effects of pollutant mixtures, analyzing differential susceptibility among sensitive populations, identifying hazards of emerging pollutants, and assessing synergistic risks under climate change scenarios. Addressing these challenges is crucial for scientifically strengthening China's air quality standard system and advancing the strategic goals of "Beautiful China" and "Healthy China".