This study conducted a survey two times at 20 points from April to June and from August to October 2022 to characterize the fish community and reveal the health of the Anyang stream. The survey collected 3,186 individuals belonging to 5 orders, 10 families and 34 species. The dominant species was Zacco platypus (43.4%), followed by Carassius auratus (10.1%), Cyprinus carpio (7.6%), Zacco koreanus (6.2%), Pungtungia herzi (5.2%), Oryzias sinensis (5.1%), Pseudorasbora parva (4.7%), Squalidus gracilis majimae (4.4%), Rhynchocypris oxycephalus (3.5%), Hemiculter eigenmanni (3.3%), Rhodeus ocellatus (1.4%), and Chelon haematocheilus (1.0%). Among the emerged species, 5 species (14.7%), including Rhodeus uyekii, Squalidus japonicus coreanus, and Odontobutis interrupta, were endemic to Korea, and 4 species (11.8%), including Cyprinus carpio (Israeli type), Lepomis macrochirus, Micropterus salmoides, and Poecilia reticulata, were exotic. The fish community analysis showed that the dominance was higher at the upper reaches of the Anyang stream and decreased downstream, and diversity, richness, and evenness were higher in tributary than mainstream. Stream health (fish assessment index, FAI) was generally poor, as it was rated as moderate (C) at seven sites, poor (D) at eight sites, and very poor (E) at five sites. Water quality was evaluated at eight sites, and it was rated as poor (V) at two sites, slightly poor (IV) at one site, moderate (III) at four sites, and slightly good (II) at one site, indicating that the overall water quality was poor and that the water quality had a significant impact on river health and fish habitat. Moreover, it was found that many weirs without fishways were constructed in the Anyang stream and became an obstacle to fish migration. Therefore, a systematic management plan to improve water quality and add fishways is necessary to improve the stream's health and conserve stable fish habitat.