Musicians in the Guangdong-Hong Kong-Macau Greater Bay Area (GBA) contribute to a cultural ecosystem but yet facing significant occupational health risks, including playing-related musculoskeletal disorders, hearing loss and performance anxiety. This mixed-method study examined the current state of health promotion and literacy among musicians in the GBA and identified gaps and priorities for sustainable career development. 150 participants (N=150) were invited for completing a structured survey and 12 participants were invited for a semi-structured interviews. Findings revealed in 3 main aspects: (1) The current level of occupational health literacy among musicians; (2) The barriers and integration occupational health content into music curricula and professional development; (3) The relationship between musician’s occupational health literacy and their self-reported prevalence of health issues. Quantitative data indicated the limited awareness and engagement on health practices, while qualitative data provided their experiences and perspectives on health promotion. Participants described the access to guidance on injury prevention, hearing protection, vocal care, and mental health was inconsistent and more than half of respondents reported they had rarely or never encountered occupational health information during their training, and were unlikely to incorporate such practices into their own playings and teaching. However, there was a strong, clearly demand for interventions that prolong career life and are encouraged for integrating into the existing educational and institutional frameworks. The study concludes that improving occupational health literacy in the GBA requires investment in training qualified teachers, establishing a structured health promotion curricula and professional development. Strengthening health promotion infrastructure has the potential to enhance wellbeing, performance quality, and career sustainability for musicians across the GBA.