Although the development of tourism has a positive impact on local employment and economic growth, the high level of energy consumption and emissions generated by tourism have also attracted increasing attention. Based on the concept of tourism eco-efficiency, this article constructs a comprehensive evaluation system for tourism eco-efficiency in China, and the study concludes that (1) China’s tourism eco-efficiency as a whole was in a fluctuating upward trend from 2002 to 2018, but different provinces of tourism eco-efficiency varied greatly, and the range of tourism eco-efficiency on spatial spill-over increased significantly; (2) the impact of tourism economic development on tourism eco-efficiency was not significant over time, and the impact of tourism eco-efficiency on the sustainable development of the tourism economy in the western region was weaker; (3) the contribution of tourism economic development to tourism eco-efficiency was low at the national level, with regional levels ranging from large to small for the western region, the central region, and the eastern region. The contribution of tourism eco-efficiency to the tourism economy was also low at the national level, with the central, eastern, and western regions ranked in descending order at the regional level.