The comprehensive problems of the Yellow River Basin (YRB) can be divided into three categories: water shortage, low-quality and low-efficiency in the industries, and insufficient development of the livelihood, except the ecological background. The main objective of the study is to adequately explore the coupling and coordinated relationship of water utilization (WU), industrial development (ID) and ecological welfare (EW) in the YRB. Compared with previous empirical studies, we establish the estimation indicators of three subsystems, and analyze the relationship and influencing factors of the subsystems of county-level cities in the YRB from 2001 to 2020 by adopting the spatial global (local) autocorrelation and Spatial Error Tobit model. Although the overall development of WU, ID and EW in the YRB had always been the highest in the lower reaches, followed by the middle and upper reaches, the coupling coordination degree (CCD) of the subsystems showed a downward trend as a whole, and there was still great potential for the improvement of the subsystems in common development. Specifically, the spatial distribution of the CCD of the subsystems presented a downward trend from the lower reaches to the middle and upper reaches, and the south of the trunk line was higher than the north. Meanwhile, the CCDs of the subsystems exhibited positive spatial autocorrelation, and the high-level CCDs were distributed in the middle and lower reaches, and vice versa, mainly located in the upper reaches. At present, the CCDs of the three subsystems in the YRB can be divided into five types: WU-led, ID-led, EW-led, synchronous development Ⅰ, and synchronous development Ⅱ. The improvement of CCD now mainly depends on the economic development, urbanization level, technological innovation and government capacity, whereas population density, environmental regulations and trade openness significantly restrained the increase of the CCD. To achieve the unity of the three subsystems in the YRB, the decision-maker should design related policies, as discussed in the countermeasures. © 2022 Elsevier Ltd