Abstract: Global bauxite resources are concentrated in Guinea, Australia and other countries, while China has limited resources and low grade, which results in an increasing reliance on external supplies. The Mid-Spine Belt region is an important bauxite-rich area in China. Bauxite development can help alleviate the imbalance of resource supply and demand, but it faces great constraints on ecological protection and technical bottlenecks. How to coordinate the relationship between rational use of resources and ecological protection is an important problem to ensure the safety of bauxite resources and the construction of Beautiful China. In this study, the entropy-weighted TOPSIS method is used to quantitatively analyze the three dimensions: mineral resources exploitation and utilization, social economic development, and ecological environmental protection in the Mid-Spine Belt region. The Coupling Coordination Degree model is then used to evaluate the coordinated development level of 32 prefecture-level cities involved. The results show that there are obvious spatial differences in mineral resource exploitation and utilization and social economic development in the Mid-Spine Belt region, and the coupling coordination degree varies across cities. Among them, cities rich in bauxite resources have made certain progress in mineral resource exploitation and utilization and social economic development, but ecological environmental protection still needs to be improved. In most cities, the coordination between mineral resource exploitation and utilization, social economic development and ecological environmental protection needs strengthening. According to the analysis of coupling coordination degree, the economic-environmental lagging cities generally show a moderate coupling coordination degree, with a prominent contradiction between mineral resource exploitation and utilization and ecological environmental protection. Mineral-environmental lagging cities perform better in social economic development, but need to further optimize green mining technology. The cities of economic-mineral lagging perform well in ecological environmental protection, but face the challenge of dual lag in mineral resource exploitation and utilization and social economic development. Policy recommendations include strengthening geological exploration, promoting green technology development, optimizing industrial chain layout, and improving ecological protection mechanisms to provide a scientific basis for bauxite development and regional sustainable development in the Mid-Spine Belt region.