Objective: Analyzing the coupling and coordination degree of medical service capacity of public hospitals and economic level in Guangdong Province from the perspective of region and city from 2016 to 2021. Methods: Stata 14.0 was used to calculate the coupling and coordination degree of medical service capacity of public hospitals and economic level in Guangdong province, and ArcGis 10.8 was used to analyze the spatial correlation and draw the Moran’s spatial distribution scatter plot. Results: From 2016 to 2021, the coupling and coordination degree of public hospitals’medical service capacity and economic level in Guangdong Province showed a slight increasing trend, but there were a large number of cities in imbalance level (17 in 2021). By 2021, the medical service capacity of public hospitals in most cities in northern and western Guangdong was ahead of the economic level. The medical service capacity of public hospitals in eastern Guangdong and Pearl River Delta region lags behind their economic level. The Moran’s I index in each year was greater than 0.3, and there was a spatial cluster distribution of the coupling and coordination degree among cities. Conclusion: The coupling and coordination level between medical service capacity of public hospitals and economic development in Guangdong Province increased slightly with years, but the overall level was not high, and the regional differences were large, showing a high, low cluster distribution. The government should continue to increase financial input in health field, pay attention to the rational allocation and benign circulation of various production factors between regions, enrich the transformation pathways, and establish a virtuous circle between these two systems.