Studying the spatial and temporal patterns of surface urban heat island intensity (SUHII) and vegetation cover in urban built-up areas and rural areas, and exploring the impact of vegetation cover in urban built-up areas and rural areas on the urban heat island effect are important bases for formulating a natural-based approach that mitigates the urban heat island effect. Using MOD11A2 land surface temperature (LST) product and MOD13A2 Enhanced Vegetation Index (EVI) product, combined with Mann-Kendall non-parametric test and Theil-Sen slope estimation, this study investigated the spatiotemporal patterns of SUHII and vegetation cover in built-up urban and rural areas of 311 cities in China during 2001—2021. Spearman correlation analysis and linear regression analysis were used to explore the relationship between SUHII and ΔEVI. It was found that: (1) the urban heat island intensity increased significantly at the rates of 0.05 ℃/a and 0.02 ℃/a, respectively (slope>0, P<0.05); (2) In summer, EVI in urban built-up areas and rural areas increased significantly at a rate of 0.0006 /a and 0.0027 /a, respectively (slope>0, P<0.05), the growth rate of EVI in urban built-up areas was smaller than that in rural areas; (3) SUHII increased with the decrease of ΔEVI in summer daytime at a rate of 0.48 ℃/ΔEVI. Nationwide, ΔEVI could explain 34% of the variation in SUHII. (4) The main pattern of SUHII enhancement in China was that the surface temperature in urban built-up areas increases faster than that in rural areas, and the ΔEVI change pattern showed a decreasing trend in EVIurban and an increasing trend in EVIrural in 56.16% of these cities while ΔEVI change pattern showed an increasing trend in both the EVIurban and the EVIrural in 40.41% of the cities. In recent 20 years, although vegetation cover in both urban and rural areas of China showed a significant increasing trend, the urban heat island intensity in summer has increased significantly. Therefore, in the context of the continuous evolution of urbanization and the intensification of climate change, increasing urban and rural vegetation construction, especially expanding the forest vegetation area in urban built-up areas, increasing urban green amount, and narrowing the difference between urban and rural vegetation can effectively alleviate the urban heat island effect.