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Objective To analyze policy documents related to healthy city initiatives, assess the current state and shortcomings of policy tools, and provide a basis for adjusting and optimizing healthy city policies. Methods Using Rothwell & Ziegfeld’s policy tools framework, a two-dimensional analysis was conducted on 26 collected policy texts. These texts were coded, classified, and subjected to frequency statistics regarding the utilization of policy tools. Results In terms of policy tools, environmental tools accounted for 57.18%, supply tools for 38.11%, and demand tools for 4.72% of the policies analyzed. Across dimensions of health action, omnidirectional interventions were the most frequently utilized at 50.98%. Notably, actions promoting a healthy environment were prevalent, constituting 13.80% of the specific policy implementations. Conclusion The application of policy tools in China’s healthy cities exhibits uneven distribution, with an overemphasis on environmental tools, inadequate utilization of demand-side tools, and overall imbalance among policy tools. It is recommended that localities adjust their use of policy tools based on local conditions, leverage the distinct roles of various tools in healthy city initiatives, and ensure effective implementation of these policies. [ABSTRACT FROM AUTHOR]