The invention discloses a smart medical management equipment and a smart medical management system based on big data, belonging to the technical field of smart medical treatment. The smart medical management equipment comprises a machine shell, a side connecting piece, a file positioning assembly, a first smashing assembly, a second smashing assembly and a vibration assembly, wherein a blocking cover is slidably installed on an inner guide rail fixedly installed on the inner wall of the machine shell, and a side connecting piece is fixedly installed on the side wall of the machine shell. According to the invention, the first smashing assembly and the second smashing assembly are installed in the equipment; when some unnecessary waste files need to be processed at ordinary times, a driving motor can be directly started, the driving motor drives the first smashing assembly to rotate, and the first smashing assembly and the second smashing assembly rotate at the same time, so waste medical files can be effectively and rapidly smashed and the using functionality of the equipment is improved; and a negative pressure air bag is arranged in the equipment, and through a linkage design, the negative pressure air bag can be extruded to exhaust air, file fragments cannot be left on the smashing assembly, and the using effect of the smashing assembly is kept.