The Ministry of Ecology and Environment announced that 19 cities were designated as pilot for regional reclaimed water reuse in November 2022, and 73.68% of the cities are located in the Yellow River Basin. By investigating the implementation of pilot cities in the Yellow River Basin, ten constraints affecting the effectiveness of the pilots were summarised, suggesting that the level of awareness of relevant local government departments needs to be raised, departmental synergies should be strengthened and working synergies should be formed. Policies and funding for pilot cities should be increased at the provincial level. Promote typical agricultural counties in the Yellow River Basin to form a model with exemplary safe use of reclaimed water for agriculture. Encouraging regions with a better foundation to carry out pilot projects for the construction of reclaimed water trading system.