Engineering construction and economic development have a far-reaching impact on the Yangtze River ecosystem through cumulative effects such as habitat homogenization and habitat fragmentation. As feedback, the reduction of biodiversity is endangering ecological stability and the ecosystem service function, thus threatening human security. To achieve the goal of "Carbon Neutrality", hydropower projects in the upper reaches of the Yangtze River will be developed on a large scale in the next eight years. As a result, the challenges of ecological restoration will be more complex and severe. Ecological restoration and carbon neutralization are China's two major sustainable development goals. Coordinated water ecological security and green development of the Yangtze River economic belt are the goals of the government's efforts in recent years. Studying the ways to achieve them has become an urgent scientific problem to be solved. By reviewing the research progress in the fields of basic ecology, river engineering, conservation ecology, and ecological restoration dynamics, this paper proposed the "5R" path for the multi-scale implementation of the Yangtze River ecosystem restoration for the whole basin, which included “Reconnetion, Restoration, Rehabitation, Recovery and Rebalance”.