As a fundamental component of school physical education, track and field plays an irreplaceable role in enhancing students' physical fitness and fostering their willpower. This study focuses on track and field teaching in middle schools, employing research methods such as literature review, questionnaire survey, and interviews. It systematically analyzes the practical dilemmas faced by current middle school track and field teaching in aspects like teaching philosophy, resource allocation, and student participation. Combined with the policy orientation of educational reform and the background of technological development, the study examines the challenges and opportunities in its development process. Finally, targeted development strategies are proposed from the dimensions of concept renewal, content innovation, teacher team construction, and resource optimization. The aim is to provide practical references for promoting the high-quality development of middle school track and field teaching and implementing the educational concept of "Health First".