Abstract: High-quality development is key to the Chinese path to modernization． To clarify the logical relationship between economy, society, ecology and urban construction in the Yellow River basin, an evaluation index system of high-quality development efficiency with multi-dimensions is built． MinDS model and coupling coordination degree are selected to calculate multisystem coupling coordination evolution of high-quality development efficiency, in different scales from 2009 to 2020． Tobit model is used to elaborate its impact mechanism． High-quality development efficiency shows a slow upward trend in general, where high-quality economic development efficiency shows an “inverted U” development trend: downstream > midstream > upstream． The efficiency of high-quality social development declines slowly: upstream > downstream > midstream． The efficiency of high-quality ecological development rises rapidly: midstream > upstream > downstream． The efficiency of high-quality urban development fluctuates steadily: midstream > upstream > downstream． The high-quality development efficiency in the whole Yellow River basin has this pattern: upstream and midstream belongs to a relatively coordinated state, downstream as a whole is close to coordination． The impacts of economic development level, industrial structure transformation, scientific and technological input intensity, scientific and technological output level, energy consumption intensity, environmental regulation, openness, infrastructure guarantee and urbanization level, on high-quality development efficiency multisystem coupling coordination, in different river basin segments, show spatial heterogeneity． Policy recommendations are made to promote high-quality development in the Yellow River basin．