[Objective] The arsenic sandstone area is the most serious soil erosion area in the Yellow River basin. Vegetation coverage changes and their driving factors were determined in order to provide a scientific reference for vegetation restoration and ecological reconstruction in this area. [Methods] MOD13Q1 NDVI data from 2000 to 2022 were used with the Sen trend, Mann-Kendall significance test, Hurst index, residual analysis, and other methods to determine the temporal and spatial variation trends of vegetation coverage during the study period in the arsenic sandstone area. The response relationships between vegetation coverage and climatic factors and human activities were also determined. [Results] ① Vegetation coverage in the arsenic sandstone area increased by 4%/yr (p<0.05) from 2000 to 2022. Vegetation coverage in the study area exhibited obvious spatial differences in the three study areas, showing the spatial distribution trends of "higher in the south and lower in the north" and "higher in the east and lower in the west". ② The area with positive correlations between vegetation coverage and precipitation during the study period accounted for 66.30% of the total area, and the area with negative correlations accounted for 33.70% of the total area. The area with positive correlations between vegetative coverage and temperature accounted for 92.19% of the total area, and the negative correlation area accounted for 7.81% of the total area; ③ The residual results showed that human activities in 2000-2011 produced mainly negative effects on vegetative coverage, and human activities in 2012-2022 produced mainly positive effects. [Conclusion] Vegetation coverage in the arsenic sandstone area significantly increased during the study period, and had a higher correlation with annual average temperature than with annual rainfall. A series of ecological protection projects have made significant contributions towards increasing vegetation coverage.