Tight sandstone water-bearing gas reservoirs typically exhibit low porosity and low permeability, with reservoir rocks characterized by complex pore structures, often featuring micron-scale or smaller pore throats. This intricate reservoir structure significantly restricts fluid flow within the reservoir, necessitating a certain threshold pressure gradient (TPG) to be overcome before flow can commence. This study focuses on the Ordos Basin and explores the influence of high water content tight sandstone gas reservoirs on TPG under different water saturation and formation pressure conditions through experiments. A mathematical model of TPG is established using multiple linear regression method. The results show that TPG is primarily affected by water saturation, followed by formation pressure. As the water saturation increases, the TPG of the core decreases, and the change becomes more pronounced when the water saturation exceeds 50%. As formation pressure increases, the weakening of the slippage effect in gas molecules leads to TPG stabilization, especially when local pressure exceeds 25.0 MPa. The research also shows that low-permeability cores exhibit greater TPG variation with pressure changes, while high-permeability cores remain more stable. A mathematical model was developed and validated to predict TPG based on permeability, water saturation, and formation pressure. These findings highlight the need to monitor formation water content during tight sandstone gas reservoir development to optimize production strategies, providing valuable insights for improving reservoir management and guiding future research.