Improving water resources utilization efficiency is critical to the development of high-quality urbanization in Beijing-Tianjin-Hebei region (BTH). An evaluation index system of new urbanization level of BTH is established to evaluate its spatio-temporal evolution characteristics, and a water resources ecological footprint model is used to reveal its water resources utilization pattern. Based on this, the coupling coordination model and spatial matching model are combined to explore their matching characteristics. Results showed that the order of new urbanization level was as follows: Beijing (0.82) > Tianjin (0.47)> cities in Hebei Province (0.1-0.4). Spatial differences could be found in their obstruction factors, Beijing was mainly restricted by ecological and urban-rural integration factors, whereas that of Tianjin and Hebei mainly came from population concern. Water resources sustainability in BTH has been enhanced, because the per capita water resources ecological footprint and footprint depth decreased, and the per capita water resources ecological carrying capacity and footprint size increased. However, ecological deficit in BTH was still severe compared with Chengdu-Chongqing urban agglomeration, and high-intensity agricultural water use was the main reason for the high-level water resources ecological footprint. New urbanization quality and water resources supply-demand were at a quasi coordination stage. In the study area, the coupling coordination degree of Beijing (good coordination) and Tianjin (intermediate coordination) showed an upward trend, but that of cities in Hebei was rather poor. The spatial matching degree between water resources ecological deficit and urbanization quality has decreased, with Hebei (matching stage) higher than Beijing (mismatched stage) and Tianjin (relatively matched stage).