With economic expansion having moderated to a “new normal” pace, the eastern coastal provinces have been given a new historical task of high-quality development and become a window and frontier of China’s high-quality development. By designing and optimizing an index system of high-quality development levels and using the entropy-TOPSIS method, the study selected 21 indicators, include economic vitality, residents’ living standards, innovation efficiency and green development, and took China’s eastern coastal provinces as an example to study the characteristics of spatial-temporal variations in the high-quality development level from 2010 to 2020. Then, the study used the obstacle degree model to explore the factors that are obstacles to high-quality development. The results show that the high-quality development of the eastern coastal provinces presents an “up-down-up” fluctuation, with an increase of 40.1%. In particular, the development level of the residents’ living standards dimension is higher, and the high-quality development level of each province shows different degrees of growth and gradually tends to balanced development, with the high-quality development of Shanghai, Jiangsu Province and Zhejiang Province in a dominant position. The spatial pattern of high-quality development in the study areas shows a spatial distribution pattern of “high in the east and low in the west, high in the north and low in the south”, in which the bipolar spatial effect of the innovation efficiency dimension is becoming more and more prominent, while the regional synergistic development effect of the residents’ living standard dimension is more obvious, and the high-quality development spatial pattern shows a “core-periphery” structure, and there is a path-dependent effect in time change, and agglomeration is produced by trickle-down effect in space. The obstacles to residents’ living standards are high, and the main obstacle factor has gradually changed from insufficient output in innovation to a reduction in the scale of foreign trade. In addition, the problems of unreasonable industrial structure and shortage of per capita public cultural resources still exist. In provinces with a high-quality development level and a relatively developed economy, the biggest obstacle factors are economic vitality and residents’ living standards. In provinces with a low level of high-quality development and a relatively backward economy, the biggest obstacle factors are green development and innovation efficiency, and there are both similarities and differences in the main obstacle factors among provinces.