[Objective]To carry out research on the evaluation of the ecosystem health level of the Gansu section of the Yellow River Basin, and to provide theoretical reference and decision-making basis for the ecological protection and high-quality development of the basin.[Methods] Based on the 2011-2021 panel data, the PSR model was used to construct an ecosystem health evaluation index system for the Gansu section of the Yellow River Basin, the entropy value method and the comprehensive index method were used to comprehensively evaluate the ecosystem health level, and the GM-ARIMA model was used to predict the ecosystem health changes in the next ten years.［Results］(1) From 2011 to 2021, the overall ecosystem health index of each city and state shows an upward trend, with Gannan ecosystem health in the Gannan Yellow River Important Water Supply Ecological Functional Area, in which Gannan ecosystem health is ranked as "inferior", Linxia ecosystem health from "inferior" to "poor", Loess Plateau Area, in which Lanzhou ecosystem health is ranked as "medium" to "good", Tianshui, Dingxi, and Pingliang ecosystem health is from "inferior" to "poor", Baiyin and Qingyang ecosystem health is in the "inferior" range, and Wuwei, a wind-sand comprehensive prevention and control area, has ecosystem health ranked as "inferior"; (2) The projected results of the ecosystem composite index for the period 2022-2031 show an increasing trend, but there is no significant change in the ecosystem health rating.[Conclusion] The overall level of ecosystem health in the Gansu section of the Yellow River Basin is not high, and current ecological protection and environmental improvement measures have not yet fully resolved the challenges facing the region's ecosystem, which will need to be further strengthened in the future by enhancing regulation and management to improve the health of the region's ecosystems.