The invention relates to a health state early warning method and device of a distribution transformer. The method comprises the following steps: collecting the load current of the distribution transformer and an ambient temperature of the environment in which the distribution transformer is located; determining a winding hot-spot temperature of the distribution transformer according to the load current of the distribution transformer and the ambient temperature of the environment in which the distribution transformer is located; and performing health state early warning of the distribution transformer according to the winding hot-spot temperature of the distribution transformer. According to the health state early warning method and device provided by the invention, the accurate real-timemonitoring of the winding hot-spot temperature of the distribution transformer is achieved by measuring the external temperature, and the voltage and the current of the distribution transformer, and the operation state of the distribution transformer is estimated to provide an important support for the overload control of the distribution transformer, the use efficiency of the distribution transformer and the safe and stable operation of the distribution transformer.