In order to explore the driving mechanism of population aging and solve the dilemma of getting old before getting rich, this paper uses ESDA to analyze the evolution characteristics and driving factors of population aging temporal and spatial pattern in the Yellow River Basin from 2000 to 2020, so as to promote the high-quality development of the Yellow River Basin. The results show that: (1) the aging of the population in the Yellow River Basin is gradually deepening, showing a ladder rising pattern from west to east; (2) the population aging in the Yellow River Basin shows a positive spatial correlation, forming a spatial pattern dominated by high-high and low-lowaggregation. Among them, high-high aggregation is mainly distributed in Shandong and low-low aggregation is mainly distributed in Qinghai; (3) population factor is the direct reason for the evolution of the pattern of population aging in the Yellow River Basin, and socio-economic factors are the fundamental reason. Therefore, from these two dimensions, this paper puts forward some suggestions on actively coping with population aging in the Yellow River Basin, such as: adhering to the comprehensive two-child policy, promoting the implementation of the three-child policy, and appropriately increasing the fertility rate; relying on the urban agglomeration in the Yellow River basin to attract the return of labor force; establishing a cross regional pension coordination mechanism to realize joint pension; vigorously developing education for the elderly and fully developing human resources for the elderly.