[Objective] Water and land resources are important factors of production for urban development. It is of great significance to explore the key factors in the utilization of water and soil resources in urban agglomerations in the middle reaches of the Yellow River to scientifically promote the rapid economic development of urban agglomerations in the middle reaches of the Yellow River. [Methods] Taking the three major urban agglomerations in the middle reaches of the Yellow River as an example, by using LMDI addition model, the decomposition models of factors affecting the change of water resources consumption and the change of urban construction land quantity were constructed respectively for the three major urban agglomerations in the middle reaches of the Yellow River from 2010 to 2019, and the effect values of different driving factors were calculated and compared. [Results] (1) Water use quota and industrial structure can inhibit the increase of water resource consumption, while economic scale and population scale will promote its increase. (2) The industrial scale, economic scale and population scale have a driving effect on the expansion of construction land, while the consumption intensity of urban construction land has a restraining effect on the expansion of construction land. (3) For the change of water resources utilization, there is a large gap in the optimization level of industrial structure among different cities in the middle reaches of the Yellow River; for the change of urban construction land, the comparison result of the total effect value of the three major urban agglomerations is Guanzhong Plain urban agglomeration > Central Plains urban agglomeration > Jinzhong urban agglomeration. [Conclusion] Discussing the factors affecting the utilization of water and land resources in urban agglomerations in the middle reaches of the Yellow River from the perspective of regional differences and time differences will help to enrich relevant research on the sustainable use of water and land resources, and provide theoretical guidance for the sustainable development of urban agglomerations in the middle reaches of the Yellow River.