In order to continuously promote water conservation efforts to alleviate the pressure of water diversion, water footprint (WF) is used as an effective tool to measure water utilization in the water-receiving areas of the Middle Route and Eastern Route of the South-to-North Water Diversion Project (SNWDP). The tempo-spatial variations of WF and spatial equilibrium of water footprint intensity (WFI) in the study area are quantified using the Mann–Kandle trend test, Sen’s slope, and Dagum Gini coefficient decomposition method for the years of 2005–2020. The results show that WF has a significant decreasing trend (Sen’s slop < 0, significant level < 0.05) in 17 cities in the study area, whereas WF shows a significant increasing trend (Sen’s slop > 0, significant level < 0.05) in 10 cities. Cities in the water-receiving areas are categorized into three types based on the contribution of the water utilization sector to changes in WF as follows: agric