The simultaneous presence of ecosystem services and damage in mining-agricultural complex areas remains poorly understood regarding their impacts on resident livelihoods and well-being. Consequently, investigating the relationships among ecosystem services, ecosystem damage, livelihood vulnerability, and resident well-being is crucial for enhancing well-being in mining-agricultural complex areas. This study focused on the Yellow River Basin's middle reaches, employing entropy methods and mediation effect models to analyze how ecosystem services and damage affect resident well-being through livelihood vulnerability mediation. Key findings include: (1) Significant positive correlations exist between provisioning services, regulating services, and resident well-being in mining-agricultural complex areas. (2) Provisioning damage shows significant negative correlations with resident well-being, particularly affecting quality of life, health status, and economic income. (3) Among livelihood vulnerability components (exposure, sensitivity, adaptability), only sensitivity mediates between provisioning services, provisioning damage, and resident well-being. Sensitivity partially mediates between supply services and resident well-being, and fully mediates between supply damage and resident well-being.