In view of the higher requirements of new urbanization development on water resource utilization efficiency, based on the panel data of 15 counties in Chongqing section of the Three Gorges Reservoir Area from 2010 to 2019, entropy method and super efficiency SBM model were used to calculate the new urbanization level and water resource utilization efficiency of the study area respectively, and Tapio decoupling model was used to explore the decoupling relationship and temporal and spatial evolution characteristics of new urbanization level and water resource utilization efficiency. The research results show that: 1) From 2010 to 2019, the level of new urbanization in the reservoir area has generally increased, and the average comprehensive index of new urbanization has risen from 0.209 in 2010 to 0.516 in 2019. The comprehensive index of the new urbanization level in the central urban area and surrounding counties of Chongqing are higher, with a multi-year average above 0.4. The comprehensive index of new urbanization level in the hinterland of Chongqing in the Three Gorges Reservoir Area are lower, but the annual average growth rate is faster, and the gap with the central urban area and surrounding counties of Chongqing is gradually narrowed. 2) The overall water resources utilization efficiency shows a trend of “decreasing-significantly increasing-slightly decreasing”. There are obvious temporal and spatial differences in water resources utilization efficiency in various districts and counties. There is a weak correlation between changes in water resource utilization efficiency and regional economic development level. 3) The decoupling relationship between new urbanization and water resources utilization efficiency has changed from strong decoupling from 2010 to 2013 to weak decoupling from 2013 to 2016 and from 2016 to 2019. The overall development trend is good. At the same time, affected by the instability of water resources utilization efficiency, the types of decoupling relationship are becoming more and more complex. The research results suggest that it is still necessary to focus on the improvement of water resources utilization efficiency in the study area in the future, and corresponding measures should be taken based on the actual situation of the study area to promote the coordinated development of new urbanization and water resource utilization efficiency in different counties.