Carrying out research on the spatial development pattern and vegetation change characteristics of urban built-up areas in the Gan-Qing-Ning region on the upper reaches of the Yellow River can provide an important reference for building a scientific and reasonable urban development system and maintaining regional ecological security barriers. Based on DMSP/OLS and statistical data, this paper extracted the urban built-up area boundaries of 21 prefecture-level cities (prefectures) in Gan-Qing-Ning region by using statistical data comparison method, and analyzed the urban expansion characteristics from five aspects:urban spatial expansion characteristics, expansion speed, dynamic degree, compactness and center of gravity transfer. On this basis, the SPOT/VEGETATION NDVI (Normalized Difference Vegetation Index) data was introduced, and the annual average NDVI was used as an indicator to represent the vegetation status in urban built-up areas. The vegetation change of urban built-up areas in the study area from 2002 to 2013 was studied from five aspects:sum, mean, ratio and its change amount, interannual change rate, percentage and stability of NDVI. The results showed that:1) As one of the effective methods to extract urban built-up area, the statistical data comparison method had high accuracy in our study area, and the error rate was within 6.7%. 2) The urban land formed a discontinuous spatial pattern of "几" around the Hexi Corridor and the upper reaches of the Yellow River, and had three different distribution patterns:point, line and plane. 3) The annual average rate and dynamic degree of urban expansion showed an upward trend, and the rate of urban expansion during 2010-2013 (4.53 km²/a) was twice as high as that during 2006-2010. 4) Except for Jiuquan, Haixi, Baiyin, Tianshui, Shizuishan and Lanzhou, the compactness index of other urban build-up areas was relatively high. 5) In the first stage (2002-2006) and the second stage (2006-2010), the center of gravity shifted northward, and in the third stage (2010-2013), the center of gravity shifted southward. 6) The total NDVI of urban built-up area increased with the increase of built-up area. 7) The vegetation in urban built-up areas showed a positive trend on the whole. From the perspective of the mean NDVI, the vegetation condition got worse from 2002 to 2006, and improved from 2006 to 2013. Moreover, the mean NDVI distribution showed obvious spatial differences, and the central and western regions were generally smaller than the eastern ones. From the perspective of the interannual variation rate and percentage of NDVI, the built-up area of each city was larger than the peripheral background area. 8) The vegetation status in urban built-up areas was generally worse than that in background areas, and the NDVI ratio and its variation in nearly 4/7 urban built-up areas showed a downward trend from 2002 to 2013. 9) Vegetation stability in urban built-up areas was poor, and the variation coefficients of more than half of the cities increased to varying degrees in the past 12 years.