Abstract: Aimed at basic theoretical issues of the mechanism's inconsistency between physical fitness test in the context of Physical Education Exam of Senior High School Entrance Examination (PESHSEE) and health, physical education (PE) and even education, the predicament of health promotion in school PE is revealed and relieved to improve the positioning of health theme in school PE and the decision-making of the reform of PESHSEE. The research shows that: ① The physical fitness test dominating PESHSEE may be difficult to promote health, and even has misalignment in the orientation introduction. The test's evaluation method has a certain degree of differentiation and competition nature, and its content may emphasizes the performance-related physical fitness indicators, weakening the proportion of the health-related fitness. ② The dominating of physical fitness test in PESHSEE is likely to lead to the distortion of the essence of physical health. As physical health is not only affected by physical exercise , and not suitable to equate physical health level with PE results; also, physical health level isn't the mainstream educational value demand of society and should not determine the education level of ordinary students. ③ The excessive emphasis on the evaluation function of physical health in the PESHSEE tends to result in the loss of the multiple value of PE, and even make PE equal to physical training. It is proposed that the physical health test should realize the return of the "feedback-incentive" purpose, and be consistent with the current "Double Reduction" concept in order to ensure the effectiveness of physical health promotion in school PE. At the same time, it should avoid the misinterpretation of the idea of "health first" completely.