Urban road transport and land use (RTLU) jointly promote economic development by concentrating labor, material, and capital. This paper presents an integrated RTLU efficiency analysis that explores the degree of coordination between these two systems to provide guidance for future adaptations necessary for sustainable urban development. Both a super efficiency Data Envelopment Analysis model and window analysis were used to spatiotemporally evaluate RTLU efficiency from 2012 to 2016 in 14 cities of Hunan province, central China. The Malmquist index was decomposed into technical efficiency and technology change to reveal reasons for changes in RTLU efficiency. These evaluation results show regional disparities in efficiency across Hunan province, with western cities being the least efficient. Eight cities showed an increasing trend in RTLU efficiency while Yueyang exhibited a decreasing trend. In 13 of 14 regions, productivity improved every year. At the same time, five regions had a decline in technical efficiency even though technical progress increased in all regions. Our analysis shows that greater investment in road transport and urban construction are not enough to ensure sustainable urban growth. Policy must instead promote the full use of current resources according to local conditions to meet local, regional, and national development goals.