<p>This study explores the relationship between visual perceptions of the street environment and perceived walkability, considering variations in self-rated health. This study employed baseline on-site survey data collected through structured questionnaires and face-to-face interviews with 626 participants in Pathum Thani, Thailand (56.4% male, 43.6% female). Multiple regression analyses were conducted to examine differences across three groups categorized by self-rated health status: individuals with good self-rated health, those with poor self-rated health, and the overall sample. The findings indicate that people with different self-rated health statuses perceive the street environment in significantly different ways. When examining the impact of the street environment on walkability perceptions within these groups, variations were observed across nine key attributes of cross-sectional proportion, street connectivity, greenness, openness, enclosure, imageability, complexity, bikeability, and street furniture. Across all groups, openness, environmental complexity, bikeability, and the presence of street furniture were consistently identified as key elements enhancing perceived walkability. Additionally, imageability was found to have a strong and significant influence on perceived walkability among individuals with poor self-rated health and across all health status groups, but not among those reporting good health. Notably, age exhibited a significant negative association with perceived walkability across all groups, suggesting that older individuals are less likely to perceive their environments as supportive of walking. These findings emphasize the vital role of inclusive urban design strategies that enhance visual coherence, spatial richness, and pedestrian-oriented features. Such interventions can foster walkable environments that promote physical activity and contribute to improved health outcomes, particularly for older adults and individuals with health restrictions.</p>