Abstract: The biggest problem in the Yellow River Basin is the shortage of water resources. To scientifically reveal the decoupling relationship between water resources utilization and economic development in water-scarce basin urban agglomerations is a major strategic management requirement for ecological protection and high-quality development of the Yellow River, and it is also a research difficulty in the interdiscipline of water science and economics. This paper developed a coupled decoupling model method based on 3D water resources ecological footprint and Tapio elastic index to identify the spatial-temporal change pattern of water resources ecological footprint and its sustainable water resources utilization level in the Yellow River Basin urban agglomerations from 2010 to 2020, and quantitatively revealed the decoupling state of water resources utilization and economic development in the Yellow River Basin urban agglomerations from multiple dimensions of size and depth. The results show that: (1) During 2010-2020, the Lanxi urban agglomeration in the Yellow River Basin has the largest water resources ecological footprint size and smallest water resources ecological footprint depth, with average values of 570.73´10⁴ hm² and 1.25, respectively. The Ningxia along the Yellow River urban agglomeration has the smallest water resources ecological footprint size and largest water resources ecological footprint depth. The mean values were 2.01´10⁴ hm² and 567.05, respectively. (2) The highest level of sustainable water resources utilization in the Yellow River Basin is in Shandong Peninsula urban agglomeration, and the lowest is in Ningxia along the Yellow River urban agglomeration. (3) The proportions of strong decoupling and expansive negative decoupling between the water resources ecological footprint size and GDP were 49.68% and 36.13%, respectively, and the proportions of strong decoupling and expansive negative decoupling between the water resources ecological footprint depth and GDP were 41.29% and 34.03%, respectively, both of which failed to reach the optimal decoupling state. The research shows that in order to improve the sustainable utilization level of water resources in the Yellow River basin, the weak decoupling between water resources ecological footprint size and GDP, and the strong decoupling between water resources ecological footprint depth and GDP is the best state.