CO is one of the major air pollutants in China and is also a contributor to the greenhouse effect. The agricultural land consumes a large amount of CO fluxes every year, and land use/cover patterns play a large role in regulating CO spatial distribution. This study focused on the spatial distribution of CO regulated by land use/cover and revealed the impacts of human activities on the spatial distribution of CO pollution in the North China Plain. The results showe that CO emissions in the North China Plain decreased from 4,964×10⁴ t to 2,683×10⁴ t from 2010 to 2020, and CO concentration in most of the agricultural land decreased from 90 t/km² to less than 45 t/km². The spatial agglomeration degree of CO concentration showed a trend of firstly decreasing and then increasing, with its Moran's I index increasing 0.25 to 0.41. The areas with more serious CO pollution were concentrated in regions with rapid economic development and formed high-high (H-H) agglomerations areas of CO pollution in Beijing and surrounding cities, and low-low (L-L) agglomeration areas in Zhoukou and Huaibei. Overall, the area where CO pollution was distributed in L-L aggregation was expanding, which to some extent reflected the preliminary effect of emission reduction measures for CO emissions. The study indicated that the land use/cover composition and configuration affected CO emission, diffusion, and oxidative, increased the uncertainty of atmospheric CO balance, and had a regulating effect on the spatial distribution of CO. In this study, the correlation between land use/cover pattern and CO spatial distribution was analyzed to explore the regulation effect of land use/cover pattern on the regional CO pollution. The research provides decision-making references for the control of CO pollution, promoting collaborative governance of pollution and carbon reduction, regional environmental quality, and the level of human settlements.