The internal reaction state of air-cooled proton exchange membrane fuel cell (PEMFC) is the key factor affecting the output performance and stability of the cell. By developing an in-situ testing device for the reaction state of air-cooled fuel cell, the real-time measurement of cell temperature and current density is realized, and the influence mechanism of hydrogen outlet pulse interval, hydrogen inlet pressure and cathode wind speed on the performance of the cell is revealed. The results show that the distribution of temperature and current density in air-cooled cells is uneven. The temperature difference can reach 20 °C, and the current density difference reaches 400 mA/cm² when the average current density is 500 mA/cm². As the interval between pulses decreases and the inlet pressure increases, the performance of the hydrogen outlet area and the uniformity of the distribution increase, which can reduce the fluctuation of current density in the cells and improve output stability. If the cathode wind speed is too low, the temperature in central areas is high, and the temperature distribution uniformity is reduced. However, excessive wind speed causes the generating water to be blown away. The water content of the proton exchange membrane thus decreases, and the uniformity of the current density distribution deteriorates.