The fast development of the transport sector has resulted in high energy consumption and carbon dioxide (CO2) emissions in China. Though existing studies are concerned with the factors influencing transport sector CO2 emissions at the national level (or in megacities), little attention has been paid to the comprehensive impact of socio-economic, urban form, and transportation development on transport sector carbon emissions and emissions efficiency in central China. This paper examines the comprehensive impact of the transport sector’s carbon emissions from six provinces in central China, during the period from 2005 to 2016, based on the panel data model. The dynamic change of CO2 emissions efficiency is then analyzed using the Global Malmquist Luenberger Index. The results indicate that, firstly, economic growth, road density, the number of private vehicles, and the number of public vehicles have caused greater CO2 emissions during the study period, while the freight turnover, urbanization level, and urban population density had repressing effects on CO2 emissions. Secondly, an uneven distribution of CO2 emissions and CO2 emissions efficiency was found among different provinces in central China. Thirdly, changes in CO2 emissions efficiency were mainly due to technical changes. Finally, we present some policy suggestions to mitigate transport sector CO2 emissions in central China.