Abstract: The Henan section of the Yellow River basin represents a vital ecological functional region in China, while its built-up areas are characterized by intensive human activities. Accurately understanding the spatiotemporal changes and evolutionary trends of ecology and economy in this section holds great significance for urban ecosystem conservation and economic development. Using the Google Earth Engine (GEE) platform, this study calculated the remote sensing ecological index (RSEI) and the remote sensing comprehensive economic index (RSCEI) of the Henan section from 2000 to 2020. Based on the interconnectivity and buffer analysis of built-up areas, this study proposed a vertical-horizontal multidimensional space analysis method to determine the coupling coordination degree of ecology and economy in built-up areas. Using this method, this study revealed the spatial development patterns of ecology-economy coupling in the study area over the past 20 years. Experimental results indicate that from 2000 to 2020, the RSEI of the Henan section trended upward initially and then deteriorated. Regarding the spatial distribution pattern, the overall socio-economic development level of this section is high in the central part and low on both sides. Specifically, the RSCEI of the western part declined gradually, while that of the eastern part first increased and then decreased. During the study period, the hierarchical coupling coordination degree within built-up areas in this section evolved from a single decline to a decrease followed by an increase and then to a sustained rise. In contrast, the coupling coordination degree outside built-up areas exhibited a distribution pattern shifting from low values nearby and high values far to an opposite trend. Overall, this study reveals the spatiotemporal distribution patterns of the coupling coordination degree of built-up areas and their surrounding areas in the Henan section of the Yellow River basin, providing technical support for urban ecosystem conservation and economic development.