Achieving sustainable development and a good quality of life depends largely on the state of the ecological environment. This research is centered on Guyuan City and examines the changes in the ecological environment quality across space and time, based on Landsat imagery and the remote sensing ecological environment index (RSEI) between 2000 and 2019. Correlation analysis and partial least squares structural equation modeling was used to investigate the environmental and human factors that affect the quality of the ecological environment. The results indicate a significant reduction in areas with a very-poor-quality ecological environment and a significant increase in excellent ecological environment management from 2000 to 2019, especially in eastern Guyuan City. The low-value area of the RSEI index gradually shifted from eastern counties to western areas relative to Guyuan City, exhibiting a significant change from a high-cluster distribution to a significantly discrete distribution. Elevation, precipitation, and total organic carbon showed significantly positive correlations with the RSEI, while temperature, land use, and pH showed significantly negative correlations. This study also reveals that topography and climate change have a positive impact on ecological changes, and urbanization is becoming less limiting for ecological improvement. In future ecological construction processes, emphasis should be placed on the terrain and climatic conditions to maximize the restoration of the ecological environment affected by urban construction. This work provides regional guidance for future sustainable development and high-quality development in the Yellow River Basin.