Land-use change plays an important role in ecological change; knowing the trends in land-use change can quickly help identify problems in regional ecosystems. In 2000 to 2020, the development of a global economy caused increasing extreme weather events worldwide and lead to exacerbating changes in types of land-use. The Yellow River source area is an important water source and a central part of ecological protection efforts in China. The fragile ecosystems make the area sensitive to environmental changes. Therefore, in protecting the ecological security of the basin, simulating changes in the ecosystem service value under different scenarios is a meaningful procedure. A patch-generating land use simulation model was used to simulate different land use scenarios in 2030, including an ecological protection scenario, a production priority scenario, a carbon neutral scenario and a natural development scenario. The analysis shows that significant progress has been made in water conservation but grassland conservation faces enormous challenges. The rate of development, occupation of farmland and land dedicated to construction has increased. Unused land increased dramatically from 2010–2020 and has not been mitigated by existing policies. Based on the unit area value equivalent coefficients, the ecosystem service value rankings for the seven land use types were as follows: Grassland > Wetland > Water Area > Forest > Farmland > Unused Land > Construction Land; the four types of ecosystem service value are ranked as follows: regulating services > supporting services > supply services > cultural services; the four scenarios of ecosystem service value are ranked as follows: ecological protection scenario > production priority scenario > carbon neutral scenario > natural development scenario. The ecosystem service value of the Yellow River source area would increase by CNY 1.641 billion in 2030 with ecological protection goals and decrease by CNY 1.421 billion with the current of development. This study provides valuable insights and implications for land use, ecological protection and sustainable development by shedding light on watershed change issues and assessing and predicting the ecological status of the Yellow River source area.