Based on the water footprint evaluation model, the energy-grain blue water footprint of 36 prefecture-level cities in the three provinces of Northeast China from 2000 to 2020 was calculated and analyzed, and the spatiotemporal characteristics of the energy-grain blue water footprint and the spatial matching relationship with water resources in the three provinces were analyzed by combining the center of gravity standard deviation ellipse and pressure index model.The results show that, during the study period, the energy water footprint of the three northeastern provinces first rises and then falls, while the food water footprint rises as a whole. The spatial distribution is affected by the differences in resource endowment, and the energy water footprint is mainly concentrated in energy-rich areas such as Daqing City and Panjin City, while the blue water footprint of food is mainly distributed in the northeastern plains, located south of the Xiaoxing’anling Mountains and west of the Changbaishan Mountains.At the beginning of the study, the degree of spatial matching between energy and water footprint and water resources was high, and the opposite was true at the end of the study. In more than 50% of the regions, the contradiction between energy and food production is prominent, and there is obvious pressure on the use of water resources. It is suggested that the three provinces in Northeast China should develop clean energy such as wind energy, solar energy, and bioenergy through technological innovation, optimize the allocation of cross-regional water resources, and improve the utilization of agricultural water resources to ensure regional sustainable development.