Abstract: Economic development is frequently accompanied by the decreased quality and dysfunctional service capacity of the ecological environment. Clarifying the relationship and spatial differences between ecology and economy is a prerequisite for sustainable regional development. Based on the remote sensing images and socio-economic data of the Dongting Lake area in 2000, 2010, and 2020, this study calculated the ecosystem service values using the value equivalent method. Furthermore, it determined the coordination and consistency indices of ecosystem services and economy in 24 districts and counties in the Dongting Lake area. Then, this study comprehensively explored the relationship between ecological services and the economy, as well as their spatial aggregation, proposing targeted optimization measures for coordinating and balancing regional ecological services and economic development. The results are as follows: ① The total ecosystem service value of the Dongting Lake area decreased from 261.541 billion yuan in 2000 to 255.646 billion yuan in 2020. The spatial distribution of ecosystem service values presented a circular layer pattern, with high values occurring in the center, followed by the peripheral mountains, while the lowest values present in adjacent hills and plains. ② As for individual ecological service values, hydrological regulation contributed the most significantly, while the nutrient cycle maintenance contributed slightly. Additionally, the values of ecological services, except for biodiversity and aesthetic landscape, decreased to varying degrees during the study period. Among them, the hydrological regulation presented the most significant reduction in the ecological service values, accounting for more than 70% of the total reduction. ③ Regarding the spatio-temporal variations in the ecological services and economic development, the Dongting Lake area showed relatively stable ecological differences and expanded economic gaps. Districts and counties in the Dongting Lake area showed high coordination degrees but low consistency levels between ecology and economy. The ecological and economic spatial aggregations exhibited significant differences, with dominant ecological aggregation zones mainly distributed within and along Dongting Lake. ④ The critical driving factors in the spatial differences in ecological service values include human disturbance, elevation, slope, temperature, and precipitation. Therefore, to promote the harmonious development of ecology and economy in the Dongting Lake area and weaken the gap between both, it is necessary to propose feasible measures for strictly protecting the natural basement, strengthening human-guided utilization, and promoting the transformation from ecological resources into economic products.