Reasonable quantitative assessment on urban ecosystem health is conducive to the sustainable development of the economy and human society. This paper quantitatively evaluated the impact of land use change on ecosystem services and ecosystem health by building a comprehensive evaluation system (vigor–organization–resilience–ecosystem services), and then analyzed the spatial-temporal pattern, evolution characteristics, and driving factors in the Shanghai–Hangzhou Bay area (SHB) over the 2000–2015 period. The results show that: the area of cropland and forest accounted for more than 65% and was mainly converted into built-up land in the past 15 years. The overall ESV showed a trend of first increasing and then decreasing. Forest accounted for the largest proportion of the total ESV, more than 60% in each year. The ecosystem health value of SBH decreased from 2000 to 2015. At the city scale, the ecosystem health was significantly deteriorated. All cities reached the lowest value by 2015. At the districts/counties scale, the number with the relatively well or well level decreased from 32 in 2000 to 20 in 2015 by 24.64% of the total area. Overall, inland regions of SBH had better ecosystem health situation than coastal areas. The rapid urbanization of population and economy were driving factors for the decline of the ecosystem health. The indicator system of integrating the vigor, organization, resilience, and ecosystem service for ecosystem health assessment is a potential method which could provide a quantitative and comprehensive way for evaluating ecological and environmental effects in the future.