Based on the theory of coupling coordination degree, this paper aims to explore the coupling and coordinated development of traditional Chinese medicine（TCM）service ability and regional economy in the Yangtze River Delta region. Methods The comprehensive evaluation model and coupling coordination degree model are constructed by using the comprehensive evaluation index system of TCM service ability and regional economy, and the spatial autocorrelation was discussed based on this. The results show that, from 2017 to 2021, the average relative development degree of TCM service ability and regional economic development level in the Yangtze River Delta region is 1.5677，1.2940，1.1862，1.1683 and 1.0382 respectively. The mean value of coupling coordination degree (D value) is 0.6287，0.6621，0.6935，0.6690 and 0.7163 respectively. The global Moran index is less than 0, indicating that there is a phenomenon of divergent aggregation. Local spatial autocorrelation analysis found that Shanghai and Anhui Province showed a low-high aggregation pattern. The service ability of TCM in the Yangtze River Delta region is developing synchronously with the regional economy. The coupling coordination degree rises from primary coordination to intermediate coordination. There are spatial heterogeneity and divergent aggregation among provinces and cities.