Analyzing the spatial relationship between humans and water is crucial for regional development and water allocation schemes, particularly in the face of extreme water scarcity in the Yellow River Basin. A quantitative evaluation model of surface water resource accessibility (SWRA) has been developed, with rural settlements serving as the research unit. This model is built upon three key dimensions: topography, distance, and surface water resources within the Yellow River Basin. The results show that: (1) The SWRA range spans from 0.13 to 0.88, with an average value of 0.47 and a standard deviation of 0.05. Higher SWRA values are concentrated in the eastern and western regions, while lower values are predominantly found in the central area. (2) The gradient of SWRA across the 12 catchments, from low to high, is as follows: Sanmenxia station, Lanzhou station, Shizuishan station, Longmen station, Tongguan station, Toudaoguai station, Xiaolangdi station, Huayuankou station, Lijin station, Gaocun station, Ai Shan station, and Tangnaihai station. (3) At the city scale, the SWRA values are generally higher in the eastern areas of 10 cities, with one exception being higher in the west. Conversely, in the western areas of nine cities, the SWRA values are lower. The remaining cities exhibit SWRA values at a medium level. The correlation coefficient between primary industry gross domestic product (GDP) and SWRA is 0.271 (N = 56, Sig = 0.043, in 0.05 level, the correlation is significant), which confirms that SWRA serves as a factor influencing GDP and is appropriately designed for assessing water accessibility. Consequently, managers can utilize SWRA results to make informed decisions regarding regional development and water allocation.