Abstract: Higher education (HE) and science and technology (S&T) are subsystems within the broader framework of economic and social development. HE serves as the primary arena for talent cultivation and human capital output, as well as a key venue for the aggregation of scientific and technological resources. Through activities such as teaching, research, and social services, HE continuously contributes talent, ideas, and outcomes to scientific progress. Simultaneously, the advancement of HE relies on the support of scientific resources and achievements to enhance its capacity, standards, and quality. Consequently, the interactive process between HE and S&T forms an open and complex system in which various elements mutually empower and coordinate with one another. Based on a deconstruction of the mechanisms underlying the coordinated development of HE and S&T, this paper employs a coupling coordination degree model, the Dagum Gini coefficient, and spatial econometric methods to analyze the temporal evolution and spatial distribution of HE–S&T coordination in China from 2010 to 2022. It also examines the spatial effects of driving factors, offering insights to promote coordinated HE–S&T development and providing a reference for global strategies toward sustainable, innovation-driven growth. The study finds that: (1) In terms of temporal evolution, the national HE–S&T coordination in China has transitioned from “moderate imbalance” to “mild imbalance” and finally to “on the verge of imbalance,” with the overall coordination level steadily increasing; (2) At the level of China's four major regions, the spatial disparities in the coordination between HE and S&T are pronounced, exhibiting an overall pattern of “eastern region leading, central region catching up, northeastern region stagnating, and western region lagging,” along with an evolutionary trend marked by “the eastern region transitioning toward high coordination while the western region increasingly departs from a balanced state.” At the provincial level, Beijing, Shanghai, Jiangsu, and Guangdong stand out as exemplary provinces of high coordination; (3) Concerning spatial disparities, the overall differences in the coupling coordination degree between HE and S&T in China are gradually narrowing, with the imbalance mainly attributable to inter-regional differences—most notably between the eastern and western regions, while the gap between the central and northeastern regions remains minimal. Narrowing the disparities between the eastern and western regions is key to addressing the overall imbalance in HE–S&T coordination; (4) In terms of spatial association, HE–S&T coordination exhibits a strong positive spatial correlation with significant positive spillover effects among provinces; (5) Analysis of the driving mechanisms indicates that for direct effects, population density and openness exert a positive influence on regional HE–S&T coordination, whereas the direct effects of economic development, infrastructure, industrial structure, and urbanization are not statistically significant. In contrast, concerning indirect effects, infrastructure and openness generate positive spatial spillovers, while urbanization produces negative spillover effects. Accordingly, it is recommended that: (1) Policies for HE and S&T be coordinated to enhance their integration; (2) Cross-regional development linkages and coordination mechanisms be established to leverage the spatial spillover effects of high-coordination provinces and cities; (3) Regional differences be acknowledged, with HE–S&T coordinated development promoted by local conditions; and (4) A favorable external environment be cultivated to drive the deep integration of HE and S&T.