Congestion, pollution, inefficient use of resources, and threats to public safety are just a few of th Malicious nodes in S-Health networks may use the Sybil attacks covered in this chapter to compromise privacy and security. The proposed system, known as SybilWatch Enhanced Privacy-Aware Smart Health (E-PASH), primarily consists of three parts: initialization, secure communication, and Sybil node detection. At startup, the Lightweight Encryption Algorithm (LEA) encrypts Smart Health Records (SHRs) utilizing prime order grouping. During the secure communication phase, encrypted SHRs are transferred to prevent unauthorized access. The cluster head is implementing the new BlueTits Detection (BTD) algorithm while simultaneously monitoring for any suspicious user behavior. By analyzing characteristics such as Master key and Last One-Time Authentication, the cluster head is able to identify Sybil nodes. As soon as the Sybil attack is detected, a fresh revocation list is promptly shared with active users to minimize the impact on privacy and system integrity.