Under the background of rigid constraints of water resources, it is of great significance to grasp the opportunities of new-type urbanization in order to promote the coordinated development of water resources and economy. Based on the provincial panel data of the Yangtze River Economic Belt from 2007 to 2020, the coupling coordination degree model, the mediation model and the spatial econometric model were comprehensively used to explore the impact of new-type urbanization on the coordinated development of water resources and economy and the mediating effect of water use efficiency. The results show that the new-type urbanization promotes the coordinated development of regional water resources and economy, and water use efficiency plays an intermediary role. And the promotion effect of the new-type urbanization has spatial spillover. Accordingly, policy recommendations are put forward such as promoting the construction of new-type urbanization in the region, steadily promoting the improvement of water use efficiency, strengthening regional connections, and promoting regional coordinated development.