[Objective] The health of the ecosystem of the Yangtze River economic belt, one of the major strategic development regions of China, was diagnosed in order to provide a scientific basis for promoting the coordinated development of the regional ecology and economic society.[Methods] ① The urban agglomerations of the Yangtze River economic belt were taken as the research area. Starting from the five dimensions of vitality, organizational structure, resilience, ecosystem services, and population health, an ecosystem health diagnostic index system for the Yangtze River economic belt was constructed. ② According to ecosystem health standards, the area was divided into the following five levels:sickness, unhealthy, sub-healthy, healthy, and very healthy. Diagnostic index weights were then determined based on the entropy weight method. ③ A normal cloud model was constructed to comprehensively diagnose the health of the ecosystem of the Yangtze River economic belt in 2000, 2009, and 2018.[Results] From 2000 to 2018, the ecosystem health level along the Yangtze River economic belt had been improved at both the overall level and at the provincial and municipal levels. At the end of 2018, the ecosystem health status of the entire study area had generally tended to the sub-health level.[Conclusion] Population density, per capita disposable income, per capita arable land area, and per capita regional GDP were the main factors affecting the ecosystem health of the Yangtze River economic belt. Therefore, it is particularly important to give attention to population development planning, increase per capita disposable income, strictly observe the red line of arable land, give attention to the scientific and healthy expansion of cities, and couple the relationship between economic development and ecological protection.