Maintaining ecosystem services (ESs) and reducing ecosystem degradation are important goals for achieving sustainable development in the arid regions. However, this topic remains unclear for the spatial-temporal response of ecosystem service value (ESV) to multiple land use decisions in arid regions of China. This study analyzed the historical transition characteristics and spatial patterns of ESV in the arid region of Northwest China from 1990 to 2020 and revealed the impact of major land conversion types (cropland expansion, grassland degradation, and built-up land expansion) on the ESV. The results show a fluctuating upward trend of total ESV from 1990 to 2020. The spatial distribution pattern of ESV from 1990 to 2020 was relatively stable, and the hot spot pattern was more prominent, with higher ESV in the northwest, northeast, and southwest regions and lower ESV in the central region. Cropland and built-up land expansion during the study period lead to significant ESV gains and losses, while the impact of grassland degradation on the total ESV decline was relatively weak. This research findings provide new insights into the spatiotemporal evolution analysis of ESV in the arid regions and provide effective guidance for formulating ecological conservation policies to achieve sustainable development goals. [ABSTRACT FROM AUTHOR]