Abstract: Coordinated development of urban and rural areas is the key to regulating the major social contradictions in the new era and serves as an important symbol of Chinese-style modernization. The urban agglomeration in the middle reaches of Yangtze River is an important support of Yangtze River Economic Belt and an important growth pole of national high-quality development. Promoting the coordinated development of urban and rural areas in the middle reaches of Yangtze River urban agglomeration is one of the important ways to improve the new development pattern of urban and rural areas. Based on the evaluation index system of coordinated urban-rural development, various quantitative analysis methods were used to reveal the characteristics of urban-rural development in the middle Yangtze River urban agglomeration and to clarify the obstructive factors that restrict high-quality urban-rural development. The results showed that: (1) The urban-rural function index of the middle reaches of Yangtze River urban agglomeration showed an overall increasing trend, the regional differences of rural function continued to narrow down, and the regional differences of urban function expanded; Spatially, the rural function index showed a “high in the west and low in the east” distribution, while the high and low values of urban function index were scattered, and the spatial pattern was developing in a balanced direction. (2) During the study period, the overall trend of urban-rural functional coupling coordination was increasing, and the urban-rural development was becoming an increasing coordination; In space, the distribution pattern showed the characteristics of “high in the west and low in the east”, but the regional differences of urban-rural coupling coordination were small and relatively stable. (3) Enhancing rural revitalization and new urbanization should solve the problems of agricultural production and culture education as a priority, leading towards a modernizing agriculture and rural areas, and the innovative urban development. Finally, based on the coordination degree of urban-rural coupling and the diagnosis of obstacle factors, further countermeasures were proposed to optimize the urban-rural integration development in the middle Yangtze River urban agglomeration.