Taking 75 prefecture-level cities (or districts) across eight provinces in the Yellow River Basin from 2006 to 2022 as the research object, green technological innovation and ecological economy evaluation indicators were constructed. The coupling coordination degree and spatiotemporal evolution characteristics of these two factors were analyzed using the coupling coordination model, kernel density estimation, and Moran’s I index. The results show that the coupling coordination level between green technological innovation and ecological economy has increased, with significant regional differences. The coupling coordination disparity between regions has gradually decreased, indicating a trend toward balanced development within the basin. Positive spatial autocorrelation exists between green technological innovation and ecological economy, but this agglomeration effect has weakened over time. These findings suggest that the Yellow River Basin’s development is becoming more coordinated, although regional disparities remain.