Ecosystem services (ES) are defined as the benefits of the natural environment that sustain human life. The analyses of the balance of ecosystem services (ES balance) and its driving factors are critical for achieving the region’s sustainable development goals. This study explored the ES balance in the Beijing-Tianjin-Hebei-Inner Mongolia (JJJM) region, considering the region’s rapid urbanization, implementation of ecological restoration projects, and intense agricultural and pastoral activities. It quantified the ES balance on different scales and selected nine natural and anthropogenic driving factors to reveal its spatio-temporal heterogeneity and change characteristics in 2000–2020. The main conclusions were as follows: (1) The ES balance in the JJJM region exhibited a significant spatial differentiation: generally higher in its eastern and northern areas and lower in its western and southern parts; (2) The ES balance in the Beijing-Tianjin-Hebei region showed a general trend of initial increase and subsequent decrease, while Inner Mongolia exhibited a continuous upward trend. High-value areas (>46) and low-value areas (