An evaluation index system for water resources utilization efficiency in Heilongjiang Province was constructed, and the primary and secondary relationships of each index were determined based on mutation theory and entropy weight method. The water resources utilization efficiency in Heilongjiang Province from 2000 to 2021 was evaluated comprehensively. The Mann-Kendall mutation test method was used to determine the mutation year and trend of water resources utilization efficiency in Heilongjiang Province, and factor analysis method was used to identify the driving factors. The results show that the average evaluation value of water resources utilization efficiency in Heilongjiang Province from 2000 to 2021 is 0.883, which shows a fluctuating upward trend over time.In terms of space, the water resource utilization efficiency in Hegang and Qitaihe areas has not changed much, while the water resource utilization efficiency in other areas is showing an upward trend. The driving factors of water resource utilization efficiency in Heilongjiang are population resource factors, water use efficiency factors, and industrial efficiency factors.