The growing demand for honey bee pollination services induces fluctuations in their populations and changes in bee health status. The current study aims to characterize the health condition of managed honey bees in three territories of the Department of Lambayeque, Peru, from a holistic perspective, considering several factors affecting bee health, including management practices, traits of the beekeepers and their apiaries, colony strength, infestation rates by Varroa sp., and the presence of agrochemical residues in bee bread. The results showed changes in land use, with large areas of crops dependent on bee pollination, determining their exposition to agrochemical residues. The 67% of bee bread samples presented pesticide residues, mainly, chlorpyrifos, carbendazim, boscalid, and azoxystrobin. In addition, limited expertise on good management practices bythe beekeepers(i.e., inadequate disinfection of beekeeping materials, unsatisfactory varroa mites' surveillance, lack of protein supplements, presence of sanitary gaps) leads to deficiencies in bee colony strength and a high Varroa sp. prevalence in the territory, altering the bee health condition. To the best of our knowledge, this article illustrates the impact of the strongly anthropized ecosystems found along Peru's coast's arid zone on managed populations of honey bees in that territory with a One Health perspective.