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This paper explores the effects of environmental regulation (ER) and rural residents’ health investment (RRHI) on agricultural eco-efficiency (AEE) to provide a reference for the Chinese Government and other developing countries for implementing environmental regulation policies and to provide new paths to further improve green development in agriculture. Using the panel data of 31 Chinese provinces from 2009–2018, the Super-SBM model was used to measure AEE. The role of ER on AEE was analyzed based on panel two-way fixed effects with endogeneity treatment and a robustness test, and this mediating effect analysis was conducted to analyze the role of RRHI in ER and AEE, examining the extent of the effect of ER on AEE in three regions of China—eastern, central and western—using a heterogeneity analysis. The results of the study show that: (1) from a national perspective, ER has a significant positive impact on AEE, showing that ER is effective at this stage; (2) when RRHI is used as a mediating variable, the rising ER’s intensity can promote AEE by increasing RRHI; and (3) the results of the heterogeneity analysis show that ER has the greatest impact on AEE in the economically developed eastern region; the western region with a weaker level of economic development is in second place. However, ER has a negative impact on AEE in the central region with a medium level of economic development. Thus, the impact of ER on AEE will show great differences depending on the stage of economic development.

Environmental Regulation, Rural Residents’ Health Investment, and Agricultural Eco-Efficiency: An Empirical Analysis Based on 31 Chinese Provinces