Ecological risk assessment (ERA) is of the utmost importance to the ecological construction of the watershed. The Yellow River Basin (YRB) is an important geographical entity in the world, covering fragile ecosystem and important socio-economic system. However, environmental challenges such as land degradation and soil erosion have seriously hindered the sustainable development. In this study, the overall status of ecological risk (ER) in the YRB was comprehensively evaluated based on the probability-loss framework. The calculation framework is constituted by four integrated assessment indicators: the landscape risk index, the erosion sensitivity index, the land desertification sensitivity index and the ecological loss index. This approach integrates the traditional landscape risk index with indicators characterizing the ecological status of the basin, while also incorporating ecosystem services as ecological endpoints. Finally, the reliability of the ER index was analyzed using uncertainty and parameter sensitivity based on Monte Carlo simulation. We found that the ER of the YRB was severe. However, there was a clear trend of overall improvement, especially in the 2015-2020 periods when the highest-risk area exhibited a more pronounced decline. Human activities had adversely affected both low and high slope areas, resulting in increasing ecological sensitivity in high slope areas. ER was increasing for all landscape types that were more affected by human activities. The results of Monte Carlo simulation based on low (20%) and high (40%) uncertainties indicate that the constructed ERA model is generally applicable in the study area. The results obtained can serve as scientific references to promote the ecological protection and high-quality development of the Yellow River basin.