Abstract: The Tarim River Basin is limited by its natural environment and low agricultural activity. The improvement of agricultural land use efficiency is an important direction for the development of agriculture in this region. This study adopted a two-stage network SBM model with consistent goals and the fsQCA method using data from five provinces (preferctures) in the Tarim River Basin from 2010 to 2020 to analyze multiple paths for improving agricultural land use efficiency in the Tarim River Basin. From the analysis of the overall efficiency of agricultural land use in the Tarim River Basin, the Bayingolin Mongolian Autonomous Prefecture has the highest agricultural land use efficiency, followed by Kizilsu Kirghiz Autonomous Prefecture, which is much higher than that of the Hotan, Aksu, and Kashgar regions. Production-stage agricultural land use efficiency was the lowest in the Hotan Region, but sales-stage agricultural land use efficiency was the highest, giving it an advantage in agricultural product sales. Production-stage agricultural land use efficiency in the Aksu Region is relatively low, and sales-stage agricultural land use efficiency is at the lowest level among the five prefectures. The level of economic development, industrial structure, industrialization level, degree of agricultural mechanization, planting structure, planting scale and other single factors are not necessary conditions for improving agricultural land use efficiency in the Tarim River Basin and require the joint action of multiple factors. There are three main paths to improve agricultural land utilization efficiency in the Tarim River Basin: the “industrialization level + degree of agricultural mechanization” dominant with “industrial structure + planting structure” edge type, the “level of economic development + industrial structure + degree of agricultural mechanization” dominant with “planting structure” edge type, and the “industrialization level + degree of agricultural mechanization” dominant with “level of economic development + industrial structure + planting scale” egde type. Therefore, policies should be tailored to local conditions and implemented accurately. For areas with agricultural land use efficiency, the government should increase investment in agricultural technology, pay attention to the tilt of agricultural resources, and improve the level of agricultural technology. For regions with high agricultural land use efficiency and good agricultural development level, we should seize industrial advantages, promote the transformation of agriculture towards standardization, digitization, and intensification, and build agriculture into a modern industry. We should grasp regional advantages and promote agricultural diversification. The natural environment and advantageous agricultural products vary across different regions (prefectures) of the Tarim River Basin. Therefore, it is necessary to combine locally advantageous products, construct brand effects, vigorously develop characteristic agriculture, and build a diversified, multilevel and multitype agricultural development system in various regions. We must improve the degree of agricultural mechanization and achieve agricultural modernization. The degree of agricultural mechanization is the core condition in all three configurations and plays a key role in improving agricultural land use efficiency. Therefore, it is necessary to optimize the structure of agricultural machinery equipment, achieve marketization and socialization of agricultural machinery services, continuously improve the comprehensive production capacity of agriculture, promote grain yield increases, increase farmers’ income, and increase agricultural efficiency. Attention should be paid to regional economic development and leverage the driving role of the industry. Research has shown that a high-quality economic level, industrial structure, and industrialization level have greatly promoted the improvement of agricultural land use efficiency in the Tarim River Basin. Therefore, it is necessary to achieve the coordinated development of various industries in the Tarim River Basin, achieve the integration of primary, secondary and tertiary industries, and comprehensively promote the diversified development of agriculture.