The achievements made since the introduction of the river and lake chief system were summarized. The reasons for the success of China’s river and lake chief system were analyzed from the aspects of national and local policy promulgation, regulation formulation, standard implementation, and professional support. The effectiveness of standardized management was proved by the cases of three typical demonstration construction areas in Shaoxing City, Fujian Province, and Jiangsu Province. The deficiencies of standardized management of river and lake chief system in policy innovation, enforcement of laws and regulations, and public participation were further explored, and relevant implementable suggestions were put forward from the three aspects of strengthening top-level design, improving assessment and evaluation, and improving water control ability.