Wetlands are vital ecosystems providing essential services to both humans and the environment, yet they face threats from human activities leading to loss and disturbance. This study utilizes remote sensing (RS) methods, including object-based image analysis (OBIA), to map and assess wetland health in Kristianstad’s Vattenrike in the southernmost part of Sweden between 2015 and 2023. Objectives include exploring RS capabilities in detecting wetlands and changes, deriving wetland health indicators, and assessing classification accuracy. The study uses Sentinel-2 imagery, elevation data, and high-resolution aerial images to focus on wetlands along the river Helge å. Detection and classifications were based on Sentinel-2 imagery and elevation data, and the eCognition software was employed. The health assessment was based on the spectral indices Normalized Difference Vegetation Index (NDVI) and Modified Normalized Difference Water Index (mNDWI). Validation was conducted through aerial photo interpretation. The derived classifications demonstrate acceptable accuracy levels and the analysis reveals relatively stable wetland conditions, with an increase in wetland area attributed to the construction of new wetlands. Changes in wetland composition, such as an increase in open meadows and swamp forests, were observed. However, an overall decline in NDVI values across the study area indicates potential degradation, attributed to factors like bare soil exposure and water presence. These findings provide insights into the local changes in wetland extent, composition, and health between the study years.