| Summary: | The health–beneficial value of urban green spaces (UGS) is increasingly accepted by scholars. However, compared to the large number of studies focused on UGS–health associations, whether UGS in high-density cities could reduce public health expenditures remains less investigated. In particular, few studies have examined the association of UGS quality with health expenditures. Therefore, we conducted a cross-sectional study in downtown Shanghai to examine such associations. A population-based household survey (<i>n</i> = 1000) was conducted to collect relevant information about different aspects of health expenditure and the characteristics of UGS. Specifically, a new method was proposed to measure UGS quality based on the supply–demand of 20 types of UGS activities. We also measured the perceived quality of different types of UGS and quantified the amount of UGS using GIS based on remote sensing data. Regression models were applied for statistical analysis. The results showed that both UGS quality based on user needs and perceived UGS quality have a significant negative association with total health expenditures. This study provides insights for UGS quality measurement, contributes to the understanding of the health-related economic benefits of UGS, and also highlights the importance of UGS optimization in high-density urban areas.
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