Abstract: The Tarim River Basin is limited by its natural environment and low agricultural activity. The improvement of agricultural land utilization 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 in the Tarim River Basin from 2010 to 2020 to analyze multiple paths for improving agricultural land utilization 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 efficiency, followed by Kizilsu Kyrgyz Autonomous Prefecture, which is far higher than that of the Hetian, Aksu, and Kashgar regions. Production-stage efficiency was the lowest in the Hotan area, but sales stage efficiency was the highest, giving it an advantage in agricultural product sales. Production-stage efficiency in the Aksu region is relatively low, and sales stage efficiency is at the lowest level among the five prefectures. The economic development level, industrial structure, industrialization level, agricultural mechanization level, planting structure, and planting scale of single factors are not necessary conditions for improving agricultural land utilization 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 “industrial structure + planting structure” auxiliary type, the “economic development level + industrial structure + degree of agricultural mechanization” dominant “planting structure” auxiliary type, and the “industrialization level + degree of agricultural mechanization” dominant “economic development level + industrial structure + planting scale” auxiliary type. Therefore, policies should be tailored to local conditions and implemented accurately. For areas with agricultural land utilization 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 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 the different regions 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 utilization 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.