The weakening of rural aging is an important manifestation of the decline of rural regional system. The deepening of the degree of rural aging and the unbalanced development restricts the promotion of agricultural modernization. This paper takes Henan Province as an example to construct the evaluation index system of rural aging and agricultural modernization respectively, analyzes the spatial-temporal pattern evolution characteristics of rural aging and agricultural modernization in the study area from 2000 to 2020 at the county scale, and divides the regional types of aging and modernization according to the coupling relationship. The results show that: 1) Rural aging has become a common phenomenon in the rural development of Henan Province, and the aging trend is enhanced and shows the trend of spreading from outside to inside. 2) The development of agricultural modernization in Henan Province showed obvious regional differences, and began to show a solidified pattern of high in the east and low in the west, high in the south and low in the north. The overall development level was low and the development gap increased first and then decreased; 3) In the past 20 years, the counties (cities and districts) in which the coupling development of rural aging and agricultural modernization in Henan Province was in a less ideal state were the most widely distributed. Therefore, Henan Province should invest scientifically in the existing resource endowment, perfect the system, and promote the coordinated development of rural aging and agricultural modernization.