The scarcity of water resources caused by the unique topography and uneven rainfall distribution in Hainan Island has become a major factor restricting local development. In order to provide effective and scientific reference basis for the overall water resource utilization status and solving this problem, this study calculated the water resource utilization situation of Hainan Island from 2017 to 2021 in detail using methods including water resource ecological footprint analysis. Furthermore, a spatial correlation analysis was conducted to examine the island’s water resource utilization characteristics, and the driving factors behind the changes in water resource utilization over the past five years were analyzed using the LMDI model. The results show that: (1) During the study period, the water resource ecological footprint in Hainan Island exhibited a slow growth trend, while the ecological carrying capacity showed a downward tendency. The per capita ecological deficit of water resources remains relatively high, and the water consumption per 10 000 yuan GDP in the whole land continues to decrease, indicating that the overall pressure on water resource demand remains high with significant regional differences accompanied by the efficiency of water resource utilization steadily improving at the same time; (2) Agricultural water use accounts for the highest proportion in the entire water use structure, while ecological water use represents the smallest share, with a year-on-year increase, indicating that Hainan Island highlights the agricultural development and is increasingly conscious of the ecological environment; (3) Significant spatial differentiation in water resource utilization characteristics exists in Hainan Island, with the western region being a hot spot aggregation area for per capita water resource ecological footprint, per capita ecological carrying capacity of water resources, water consumption per 10 000 yuan GDP, while it is a cold spot cluster area for per capita ecological deficit of water resources. The opposite holds true for the eastern region of Hainan Island; (4) Economic and technological factors have a major impact on the changes in water resource ecological footprint within the designated area. Among them, economic factors drive the growth of the water resource ecological footprint in Hainan Island, and exacerbate local water resource consumption, while technological factors negatively contribute to the amount of water resource utilization in Hainan Island, indicating that advanced technology has improved water resource utilization efficiency and significantly reduced water resource consumption.