Analyzing LULC dynamics and ecosystem services is of great significance for both revealing the potential issues of surface change and creating ecological awareness and actions. The Yellow River Basin is a vast geographical unit integrating fragile ecosystems and crucial socio-economic systems, in which development and conservation have coexisted and coevolved over decades. Here, we explored the evolution characteristics of land use/land cover (LULC) changes from 2000 to 2020 and predicted the future changes in 2030. On this basis, the ecosystem services were assessed and predicted correspondingly on established grids, administrative divisions, and the basin. Analyses show remarkable progress in reforestation and water protection and great challenges of grassland protection. Cropland keeps declining at a reduced change rate from 1.7% to 0.7%, with its developed and occupied rates intensifying. Grassland degradation and transition are increasingly severe, with its reduction rate doubling in the second decade. Large-scale and repeated conversions between cropland and grassland indicate their spatial conflicts in the upstream fragile zone but fail to be mitigated by existing policies. Land use intensifies over time and successively from upstream to downstream in space, with construction land increasing by 23.2% and 68.2% in the past two decades, respectively. Based on predictions by the Patch-generating Land Use Simulation model, we found higher risks of downstream cropland loss and grassland degradation in 2030. Construction land was estimated to increase dramatically by 34.5%. The basin's total value of ecosystem services (ESV) was estimated to increase by 13.87 billion CNY during 2000–2010 and decrease by 5.27 billion CNY during 2010–2020, likely to reduce by 5.40 billion CNY in 2030. Values of provisioning services, regulating services, supporting services, and cultural services change follow the same inverted V-shape changes as the ESV, anticipated to decline by 0.5%, 0.4%, 1.6%, and 1.1%, respectively in 2030. This study on the river basin offers valuable insights and implications on land use, ecology protection, and sustainable development via revealing the LULC change issues, assessing and predicting the ecological status. © 2022 The Authors