Analysis of land desertification sensitivity is an important part of the wind break and sand-fixation ecological function assessment. The spatial distribution pattern and dynamic change of land desertification sensitivity in 14 provincial-level regions of Northern China from 2000 to 2018 were evaluated with the vegetation coverage, moisture index, days of strong wind, slope and sand content in surface soil as evaluation indexes. Five classes of land desertification sensitivity ranging from extreme to low were generated, namely extreme sensitivity zone and high sensitivity zone (high-sensitive desertification grade), moderate sensitivity zone (moderate-sensitive desertification grade), low sensitivity zone and non-sensitivity zone (low-sensitive desertification grade). Results showed that the land area of high-sensitive desertification grade decreased from 48.1% to 40.4% with a decline of 0.4% per year, and the land area of low-sensitive desertification grade increased from 30.3% in 2000 to 38.8% in 2018, showing the tendency of transition from high-sensitive desertification grade to middle and low-sensitive desertification grade in Northern China. The spatial distribution pattern of land desertification sensitivity in 2000, 2010 and 2018 showed that area of high-sensitive desertification grade was mainly distributed in the desert aggregation zone and its adjacent areas in the western and Northern China, with low vegetation coverage, and dry and windy climate; area of low-sensitive desertification grade was mainly distributed in Da and Xiao Hinggan Mountains, Changbai Mountains and Qinling Mountains with high vegetation coverage and relatively humid climate; area of moderate-sensitive desertification grade was located in the buffer areas of the two. Compared with 2000, the sensitivity of land desertification in the desert aggregation zone in the western and Northern China remained stable, however, the land area of high-sensitive desertification grade in Mu Us sandy land, Horqin sandy land and Hunshandake sandy land, which were located in Inner Mongolia, Ningxia and their surrounding area, decreased significantly in 2018. The remarkable increase of vegetation coverage caused by the temperature rising, precipitation increasing and a series of ecological protection engineering as well as the decrease of strong wind days were important factors for this change.