Abstract: To explore the relationship between water resources utilization and industrial development in the upstream mountainous area of Yangtze River Economic Belt and promote their coordinated and sustainable development, Guizhou Province was taken as the study area. The comprehensive weighting method, linear weighting method, coupled coordination model, and relative development model were employed to analyze the interrelationship and evolution trends between water resources utilization and industrial development from 2004 to 2023. The results showed that: ① With the continuous improvement of water use efficiency and industrial investment, both the water resources utilization level and the industrial development level in the study area exhibited a significant upward trend over the past 20 years, with their indices increasing from 0.218 and 0.249 to 0.774 and 0.579, respectively. ② The coupling coordination degree between the two systems increased from 0.483 to 0.818, progressing from near-dysfunctional to well-coordinated, indicating a gradual shift towards a coordinated and sustainable relationship. ③ The industrial development level in the study area was relatively lagging behind. In the future, while maintaining steady growth in water resources utilization, it is necessary to increase industrial investment and further promote industrial development. The findings can provide a theoretical basis for formulating and improving regional policies and promoting high-quality development in the upper reaches of Yangtze River Economic Belt.