Over the past two decades, strategies for sustainable development and water environment governance have become the main ways to improve regional water-use efficiency. However, the evolutionary characteristics and drivers of the regional water-use efficiency remain unclear, and the effectiveness of national strategic instruments must still be evaluated. The study uses the minimum distance to the strong efficient frontier model (MinDS) to measure water-use efficiency in the Yangtze River Economic Belt, examines the evolutionary characteristics of water-use efficiency from spatial and temporal perspectives, and further investigates drivers of the evolution of the water-use efficiency. The results indicate that the water-use efficiency in the Yangtze River Economic Belt has greatly improved and been maintained at a high level, especially after the national strategy for this economic belt was established. Water-use efficiency improvement is closely related to water environment treatment. There exists a significant spillover effect on the water-use efficiency in the provinces of the Yangtze River Economic Belt. High-level provinces are helpful in driving neighboring provinces to improve their water-use efficiency, while low-level provinces play a negative role. This study confirms the effectiveness of the national strategy and provides a useful perspective for interprovincial water-use efficiency improvement.