The realization of green and sustainable development of agriculture is the common pursuit all over the world. Agriculture green development (AGD) program has been proposed as a sustainable development strategy in China, but insufficient is known about the quantitative evaluation of spatiotemporal variation in AGD at the regional scale. This study aimed to assess spatiotemporal patterns in AGD at the county/city-based regional level. For this purpose, a systematic index evaluation system was developed to assess the performance of socioeconomic, food production and environmental components in a key economic region (Hainan Province) of China. Hainan improved its AGD index (representing the overall performance toward achieving AGD) from 38.8 in 1988 to 40.9 in 2019. The socioeconomic development and agricultural productivity have improved with time; environmental quality declined due to overuse of chemicals from 1988 to 2013, but steadily improved after 2013, indicating positive effects of reducing chemical input. There was a higher AGD index in the coastal vs. central regions and the southern vs. northern regions. Scenarios featuring improved nutrient management or optimized diet structure and reduced waste improved economic benefits and social productivity while concurrently reducing environmental degradation. These results provide new insights for the future development of green and sustainable agriculture and formulation of agricultural policies in Hainan Province of China and even other developing countries that are facing or will soon face similar challenges.