Land use change plays a crucial role in global environmental change. Understanding the mode and land use change procedure is conducive to improving the quality of the global eco-environment and promoting the harmonized development of human–land relationships. Large river basins play an important role in areal socioeconomic development. The Yellow River Basin (YRB) is an important ecological protective screen, economic zone, and major grain producing area in China, which faces challenges with respect to ecological degradation and water and sediment management. Simulating the alterations in ecosystem service value (ESV) owing to land use change in the YRB under multiple scenarios is of great importance to guaranteeing the ecological security of the basin and improve the regional ESV. According to the land use data of 1990, 2000, 2010, and 2018, the alterations in the land use and ESV in the YRB over the past 30 years were calculated and analyzed on the basis of six land use types: cultivated land, forestland, grassland, water area, built-up land, and unused land. The patch-generating land use simulation (PLUS) model was used to simulate the land use change in the study area under three scenarios (natural development, cultivated land protection, and ecological protection in 2026); estimate the ESV under each scenario; and conduct a comparative analysis. We found that the land use area in the YRB changed significantly during the study period. The ESV of the YRB has slowly increased by ~USD 15 billion over the past 30 years. The ESV obtained under the ecological protection scenario is the highest. The simulation of the YRB’s future land use change, and comparison and analysis of the ESV under different scenarios, provide guidance and a scientific basis for promoting ecological conservation and high-quality development of river basins worldwide.