Abstract: To reduce the water environmental risks caused by inadequate construction and suboptimal management systems in industrial wastewater treatment plants (WWTPs) in the Yellow River Regions and to solve the problems of limited province-scale review studies due to the complexity of such studies, challenges in obtaining large-scale and high-density data, and regional data access barriers, the operation data of industrial WWTPs in Gansu Province from 2022 to 2024 is statistically analyzed to explore their operation status and existing problems based on questionnaire survey and field research. The results show that three types of common problems exist in Gansu′s industrial WWTPs: construction design issues, treatment effectiveness, and poor operation effectiveness. The proportion of wastewater treatment reliance, operation load, and proportion of low standard compliance are 50%, 47.4% and 34.4% respectively, and the operation cost is 3.91 RMB/m³. A ‘one-map’ of operation problems at the overall and basin levels is formed. Specifically, the WWTPs in the Yellow River Basin of Gansu Province have two types of major problems: construction design flaws and treatment inefficiencies, including a high proportion of wastewater treatment reliance, low rates of technological upgrades, and high rates of low standard compliance. In the WWTPs in the Northwest River Basin, the main problems involve treatment and operation effectiveness, including low operation loads, high sludge yields per unit, and high operation costs. Compared with the above two basins, the operation problems of WWYPs in the Yangtze River Basin of the Gansu Province are not obvious. Based on these specific operation problems and with the goal of reducing pollution and carbon emissions, it is recommended to improve infrastructure construction, increase operation load, optimize operation management models, and promote the transformation of operation management from end-of-pipe control to the full-process optimization in the Yellow River Region.