With economic progression in China, Yellow River Basin serves as a critical economic belt, which has also been recognized as a cradle of Chinese culture. A watershed is a complex structure of social, economic, and natural factors, and the diversity of its components determines its complexity. Studies on the spatiotemporal distribution characteristics and factors influencing the tourism eco-efficiency at the watershed scale are crucial for the sustainable regional socio-economic development, maintaining a virtuous cycle of various ecosystems, and comprehensively considering the utilization and coordinated development of various elements. Based on tourism eco-efficiency, the coordination degree of regional human–land system and the sustainable development levels can be accurately measured. With the tourism eco-efficiency in the Yellow River Basin from 2009 to 2019, the present study considers 63 cities in the Yellow River Basin as the research area by adopting the super-efficiency slacks-based measure (Super-SBM) model. Methods such as trend surface analysis, spatial autocorrelation analysis, elliptic standard deviation analysis, and hot spot analysis were used to explore their spatiotemporal distribution and evolution characteristics. The geographical and temporal weighted regression (GTWR) model was used to determine the factors influencing the tourism eco-efficiency value. The findings are as follows: ①The level of tourism eco-efficiency in the Yellow River Basin is not high, exhibiting a fluctuating upward trend. ②The tourism eco-efficiency in the Yellow River Basin shows significant spatial interdependence and agglomeration. Furthermore, the track of the center of gravity moves from northeast to southwest. ③ The tourism eco-efficiency in the Yellow River Basin is affected by various factors, with the economic development level having the greatest influence.