The services provided by grassland ecosystems are important and irreplaceable in maintaining the balance and stability of ecosystems. The spatiotemporal variations of grassland ecosystem service value (ESV) and its influencing factors in Inner Mongolia from 2000 to 2019 were studied in this paper. Based on the socio-economic data, remote sensing data, geographic data, and meteorological data, a dynamic ESV assessment method based on the equivalent factors was used to calculate the grassland ESV for each year. The spatiotemporal dynamic variation and future trend of grassland ESV were studied by coefficient of variation index (CV), Theil–Sen median trend analysis, Mann–Kendall test, and Hurst index, and the Geodetector was used to determine the main factors affecting the distribution of ESV. The results indicated that (1) the annual average grassland ESV of Inner Mongolia was higher in the northeast than in southwest, the average ESV was 2.0794 million CNY/km2, and the pixels were concentrated from 1 to 3 million CNY/km2, accounting for 75.46% of the study area; (2) during the study period, the average grassland ESV increased slowly with time at an annual growth rate of 0.2, and the total ESV decreased first and then increased with the change in grassland area; (3) the average volatility was 0.16, and pixels with CV values between 0.1 and 0.2 accounted for 69.2% of the study area, indicating the fluctuation of ESV was relatively stable during the study period; (4) 37.16% of the grassland ESV in Inner Mongolia decreased slightly and 41.77% increased slightly during these years, and the two parts showed opposite trends in the future; and (5) the single factor influencing the spatial distribution of grassland ESV was mainly normalized vegetation index (NDVI) and precipitation, and the multi-factor interactions were NDVI∩slope and NDVI∩precipitation. All influencing factors exhibited a stronger impact through the two-factor interaction. This study can provide reference values for the policymaking of natural resource conservation or restoration.