The case study for this analysis is Henan province in China, where sustainability is a central issue for tourism development due to the area’s enormous and unexploited potential for cultural tourism. We construct a cultural tourism industry competitiveness evaluation index from cultural resource competitiveness, economic development support competitiveness, ecological environment competitiveness and basic guarantee competitiveness, and also construct a tourism flow evaluation index from tourist flow, consumption flow and effect flow. For this study, we then adopt an Entropy-TOPSIS and Coupling Coordination model to analyze the characteristics of coupling and coordinated development of them from 2009 to 2019. The empirical results show that (1) the comprehensive development index of cultural tourism industry competitiveness and tourism flow exhibits a fluctuating rise trend and maintains good development momentum; and (2) the coupling coordination degree between the cultural tourism industry competitiveness and tourism flow in Henan Province as a whole is gradually improving and the coupling coordination level developed from extreme disorder to grudging coordination, but it is unpromising in some parts of cities. Some recommendations are provided to promote the coupling and coordinated development of cultural tourism industry competitiveness and tourism flow for cities.