Based on a three dimensional water ecological footprint model, an index evaluation system of sustainable utilization of water resources was constructed with four indexes, including water ecological deficits and surplus, water pressure index, water resources intensive use index and water resources sustainable index. Then, the sustainable utilization level of water resources in Henan Province was analyzed from spatial and temporal perspectives, and the driving factors of water footprint change was also discussed using logarithmic mean Divisia index analysis. The results show that the water footprint of Henan Province from largest to smallest is production water ecological footprint, domestic water ecological footprint and ecological water ecological footprint, and the water footprint depth of the cities in eastern Henan and central Henan is larger. Moreover, the overall sustainable utilization of water resources in Henan Province is poor, among which the cities in north Henan and central Henan have the worst performance. Economic scale effect and population scale effect have a positive driving influence on the changes of water footprint, whereas intensity efficiency effect of water footprint and water resources carrying capacity effect have a negative driving influence.