Abstract: Urbanization and cultivated land use have presented a complex and dynamic relationship. This study aims to reveal the coupling and coordination relationship between urbanization and cultivated land use ecological efficiency, together with the driving factors behind it. The statistical data was collected from the 88 prefecture-level cities (states and leagues) in the Yellow River Basin from 2005 to 2020. The comprehensive evaluation was then adopted to measure the urbanization development level using the SBM-Undesirable model, and the coupling coordination degree model. The cultivated land use ecological efficiency and the coupling coordination degree were achieved after evaluation. The results show that: 1) The development level of urbanization increased steadily, but there was a much more outstanding feature of spatial differentiation. The first echelon of urbanization was gradually distributed in the downstream coast of the Yellow River, the middle and upper reaches of the northern part of the Yellow River; The ecological efficiency of cultivated land use was significantly improved with the imbalance of high in the middle and low in the surroundings in the local areas. 2) It continued to rise the coupling coordination degree between urbanization and cultivated land use ecological efficiency. But there was no reach in the advanced level of coordination. The extreme situation of 'high in the east and low in the west' in the spatial distribution gradually evolved into the polycentric high in the middle and low in the surroundings pattern of differences. The overall spatial differences were gradually narrowing to evolve into the high in the middle and low in the surroundings pattern. Two types of coupling coordination were the high-high and low-low agglomeration. Among them, the high-high agglomeration was concentrated mainly in the downstream areas, such as Shandong and Henan Provinces. While the low-low agglomeration was mainly concentrated in the upstream areas of Gansu Province. 3) There were the influencing factors on the coupling coordination degree between urbanization and cultivated land use ecological efficiency, such as the scale of cultivated land operation, the income level of farmers, the government's agricultural support, the elevation, the average annual precipitation, and the average annual temperature. There was a non-linear and two-factor enhancement of the interaction among the driving factors. Therefore, much effort should be continued to narrow the gap between the development level of urbanization and the cultivated land use ecological efficiency among regions. In addition, breakthroughs and upgrades should be promoted in the level of coordination between urbanization and the cultivated land use ecological efficiency. The demonstration and leadership were found in the high-high agglomeration areas. Finally, it is necessary to take the regional background as the primary determinant of urbanization development and arable land use. While the interaction and complementary enhancement of each factor can be fully considered to synergistically improve the coordinated development of regional urbanization and arable land use.