Excessive dependence on land finance (hereafter LF) in China’s urbanisation process has generated various problems and compromised the interests of future generations, hence a transformation from “land urbanisation” to “population urbanisation” is now called for. Nevertheless, before turning towards a new urbanisation strategy, the spatio-temporal variances of LF and associated risks for regional sustainability deserve further investigation. This study developed a comprehensive evaluation indicator system from administrative, economic, social and ecological perspectives, to evaluate the LF risks at provincial scale in mainland China from 1998 to 2017, applying the combined AHP-Entropy method and Multi-Criteria analysis. The results indicated that land transfer dependence remained high across all provinces over the last two decades, and the LF risk increased accordingly. In 2015, economic, social, and total risks of China as a whole all reached a “high” risk level, ecological risk was at the level of “critical”, although administrative risk kept going down and was at a “low” risk level in recent years, thanks to the persistent nation-wide effort on cracking down on corruption. Spatially, total LF risk generally presented a declining gradient from east to west. Through analysing the tentative and plausible causes to above spatio-temporal variances, five policy suggestions were put forward: (1) reforming current cadre assessment and fiscal decentralisation systems; (2) transforming the residential housing supply structure; (3) establishing a comprehensive land ecological conservation system; (4) promoting a flexible leasehold mechanism in primary land market; and (5) restructuring the industrial layout to defuse differentiated LF risks across provinces. With empirical data and comprehensive risk evaluations, this study contributed to improve our knowledge on the spatio-temporal patterns of LF and its associated risks at provincial scale, helped to inform future urbanisation policy designs and ultimately to promote regional sustainability for China and beyond.