Global change is becoming increasingly evident, and human activities are also causing severe damage to natural resources and the environment. Therefore, it is increasingly important to study regional sustainability in order to guide human decisions and actions. The ecological footprint is a useful indicator with which to quantify the pressures imposed by humans on natural resources and regional capacities for sustainable development. This paper analyzed the variations in the ecological footprints and capacity for regional development of five provinces in Northwest China in 2005-2014, based on the Wackernagel ecological footprint method, using the standard measurement of the national hectare. The ecological footprints of the five provinces were quite different, mainly because of the differences in arable land and fossil energy resources. The average ecological footprint in Shanxi was relatively high over the study period, at 22,549.86 thousand NHA, which had the greatest demand for natural resources, whereas that of Qinghai was relatively low, at 4163.20 thousand NHA. The ecological footprint in Northwest China increased from 57,770.19 thousand NHA in 2005 to 96,501.66 thousand NHA in 2014, predominantly attributed to the growth of the fossil energy ecological footprint (coal accounted for 72.88%, crude oil accounted for 14.97%, and coke accounted for 6.67%). The changes in the ecological footprint per 10,000 CNY gross domestic product, the ecological footprint diversity index, and the development capacity index in the study period revealed an increase in the comprehensive development capacity in this region, which should improve the regional capacity for sustainable development, but the stability of the eco-economic systems in Shanxi, Ningxia, and Xinjiang require improvement. This analysis provides the reference information for the construction of an ecologically viable civilization in Northwest China and the scientific foundation for the implementation of the Belt and Road Initiative.