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With the increasing world multipolarization, economic globalization, cultural diversity and social informatization, all countries in the world have adopted key competencies as an important part of education research. As a programmatic document of physical education in the new century, physical education and health curriculum standards play an important role in the demonstration and promotion of quality education. The purpose of this study was to compare the Chinese and United States (US) high school physical education and health curriculum standards from the perspective of key competencies. Using literature review, this study compared the high school physical education and health curriculum standards between China and US with five aspects: curriculum nature and concept, curriculum objectives, curriculum content, academic quality, and learning evaluation. The key competencies connotation of physical education and health curriculum standards in China and US are relatively consistent, both of which centered on improving and maintaining students' health and well-being, and were multidimensional including aspects of sports ability, sports cognition, healthy life, social behavior, emotional attitude and values; The standards structure of physical education and health curriculum in China appeared to be more complete (with specific focus on sports skills), the content scope was more detailed, the learning objectives needed to be more specific, the learning requirements were clear, but the learning evaluation still needed to be further enriched; The structure of the US physical education curriculum standards was relatively loose, had clear and multi-level learning goals, high learning requirements, operable evaluation content, with curriculum content focus on cultivating students' lifelong sports habits. We should firmly implement the guiding ideology of health first, adhere to the core quality of physical education, and emphasize the parallel relationship among sports ability, healthy behavior and physical education morality. However, we should not blindly pursue the average development in the specific teaching process. China should pay attention to the evaluation of physical education learning, further enrich its content, especially the evaluation methods and means of students' internal performance. We should correctly grasp the principle of "tightening" and "relaxing" when dealing with the key competencies, and attach importance to the on-the-job training of front-line physical education teachers.