On the basis of the “combined management of Three Waters”, this paper constructs a water management performance evaluation system that includes three dimensions: the utilization of water resources, water environment management, and the rehabilitation of water ecosystems. It evaluates the water management performance of the Yellow River Basin from 2006 to 2022 using entropy weight TOPSIS. This includes characterizing the dynamic evolution of water management performance in the Yellow River Basin with the help of kernel density curves, exploring the differences in water management performance between the upper, middle, and lower reaches of the Yellow River Basin with the help of the Tyrell’s index, and assessing the development trend of the Yellow River Basin using the GM (1,1) prediction model. The results show that the overall water management performance of the Yellow River Basin shows a decreasing trend and then a stable upward trend, and the dimension of the utilization of water resources of the Yellow River Basin shows a spatial pattern of strong in the east and weak in the west. In contrast, the dimension of water environment management shows a spatial pattern that is strong in the west and weak in the east. The kernel density curve shows that the gap between the water management performance of the provinces in the basin continues to increase over time and tends to stabilize. According to the model, the performance of water management in the Yellow River Basin will continue to improve steadily in the coming years.