Dongying City is located at the mouth of the Yellow River, with a long coastline, and its urban ecosystem and climate are significantly influenced by the marine environment. Considering the intense development activities in the Yellow River estuary area and their profound impact on the ecological environment, this study aims to comprehensively assess the ecological health status of the Yellow River estuary, with Dongying City as the study area. Based on the literature analysis method, key indicator factors affecting the ecology of the Yellow River estuary were screened using Pearson correlation analysis and principal component analysis, and 23 indicator factors were selected based on the DPSIRM model. By combining the improved AHP-CRITIC-Entropy weight method and the comprehensive index method, an integrated ecosystem health evaluation system was constructed, and the ecological health status of the Yellow River estuary from 2010 to 2022 was analyzed. The study found that during this period, the ecosystem at the Yellow River estuary generally maintained a sub-healthy to healthy state, with an overall trend of steady improvement. Particularly since 2020, the ecosystem has entered a relatively stable and healthy state. In 2022, the ecological health index reached 0.7077, reflecting a trend towards a healthy development of the Yellow River estuary ecosystem.