The present invention provides a health file access control system and method in an electronic medical cloud. The system comprises: a medical management center unit configured to generate a system public key and a system private key, and generate a private key for corresponding utilizer's attributes according to the system public key, the system private key, and a set of utilizer's attributes; an electronic medical cloud storage unit configured to receive and store a privacy-protected health file ciphertext; and at least one health file user access unit configured to encrypt the health file according to the system public key to obtain the privacy-protected health file ciphertext, and/or generate the set of utilizer's attribute, and decrypt the privacy-protected health file ciphertext according to the system public key and the private key for utilizer's attributes. The health file access control system and method in the electronic medical cloud provided by the present invention not only ensure the confidentiality of the health file, but also improve the security and calculation efficiency of the health file access.