The characteristics and evolution trend of water use structure in the Yangtze River Economic Belt are analyzed according to the changes in water consumption of eleven provinces (cities) from 2003 to 2020 by using theoretical methods of information entropy and equilibrium degree. The driving forces are also examined via principal component analysis. Results manifest that on the time scale, the total water consumption of the Yangtze River Economic Zone is on the rise. The proportion of agricultural and industrial water consumption has declined, while the proportion of domestic and ecological water consumption has increased; the information entropy and equilibrium degree of water use structure have both increased, and the water use system is more balanced. On the spatial scale, the water consumption system in the lower reach of the Yangtze River Economic Belt is the most balanced, followed by that in the upper reach and the middle reach in sequence. With the adjustment of agricultural structure, it is expected that the area of arable land in the Yangtze River Basin may shrink, and the amount of agricultural water consumption will not rise sharply, with its proportion continue to drop. It is expected that industrial water consumption may fall, and its proportion will still decrease; domestic water consumption will continue to increase. The major driving forces for the evolution of water use structure are total industrial production value, GDP, water-saving irrigation area, and water consumption per 10 000 yuan of GDP, together contributing 96.8% to the changes.