The Northeast Black Soil Belt is a crucial commercial grain production base in China, in recent years, soil quality degradation, soil erosion and other issues have a direct impact on the security of ecology and security of food supply. In order to clarify the characteristics of land use change and evaluate the ecological sensitivity of the Northeast Black Soil Belt, we take the five periods of land use data of the Northeast Black Soil Belt in the years of 2000, 2005, 2010, 2015 and 2020 as the basis, and use the methods such as transfer matrices, geodetector, and comprehensive ecological risk evaluation to study the landscape pattern and ecological risk change trends. The results were as follows: (1) During the period of 2000—2020,unused land and water land use in the study area changed most obviously, increasing and decreasing by 1 035.7 and 975.8 km², respectively, and arable land was the land use with more drastic changes in phases; (2) Different natural factors exhibited significant differences in explaining land use types in the study area. Temperature was the dominant factor influencing land use changes, while wind speed showed significant synergistic enhancement when interacting with elevation, temperature, evaporation, geothermy, atmospheric pressure, humidity and daylight duration factors in land use changes. (3) Over time, the overall ecological sensitivity of the study area has improved. Highly sensitive regions had decreased, mildly sensitive regions had increased. Additionally, there was a trend of high-value ecological sensitivity areas moving northward and low-value areas moving southward, the high-value ecological sensitivity regions may be related to erosion which dominated by wind erosion. The analysis of macro-scale landscape pattern changes and ecological risk assessment are of great significance to the formulation and implementation of regional ecological environmental protection policies.