Based on the theory of coupling coordination degree，this paper aims to explore the coupling coordinated development of traditional Chinese medicine（TCM）service ability and regional economy in the Yangtze River Delta region. The comprehensive evaluation model and coupling coordination degree model are constructed using the comprehensive evaluation index system of TCM service ability and regional economy to explore the spatial autocorrelation. The results show that from 2017 to 2021，the average values of the relative development degree of TCM service capability and regional economic development in the Yangtze River Delta region are 1.567 7，1.294 0，1.186 2，1.168 3 and 1.038 2 respectively. The mean coupling coordination degree （D value）is 0.628 7，0.662 1，0.693 5，0.669 0 and 0.716 3 respectively. The global Moran’s index is less than 0，indicating the existence of a divergent aggregation phenomenon. The local spatial autocorrelation analysis found that Shanghai and Anhui Province showed a low-high aggregation pattern. In general，the service ability of TCM in the Yangtze River Delta region is developing synchronously with its regional economy. The coupling coordination degree rises from primary coordination to intermediate coordination. There is spatial heterogeneity and divergent aggregation among provinces and cities.