It is of great significance to study the changes of sustainable use of water resources in arid areas to ensure the sustainable development of water resources, water resources and ecological environment. In order to fully understand the development level of sustainable utilization of water resources in Hotan area and the main obstacles to its development, this paper constructs an evaluation model of sustainable utilization of water resources in Hotan area based on “PRS” model from three aspects, such as pressure, state and response ability of water resources system. Based on TOPSIS algorithm and obstacle degree model, the evolution characteristics and obstacle factors of sustainable use of water resources were revealed. The results show that: (1) From 2000 to 2020, the sustainable utilization of water resources in Hotan area shows a fluctuating upward trend, and the calculated value is mainly 0.4-0.8; (2) From the perspective of water resources system pressure, state and response, the state, response level and pressure level of water resources in Hotan area show a fluctuating upward trend from 2000 to 2020, and their added values are 0.589, 0.400 and 0.674, respectively. Among them, the closeness degree of water resources system pressure increases the most, about 2 times. (3) The sustainable utilization of water resources in Hotan was mainly affected by evaporation change rate and vegetation coverage rate. This study believes that the industrial structure should be adjusted, the discharge of sewage and the development and utilization of water resources should be strictly controlled, the utilization rate and economic benefits of water resources should be improved, and the sustainable utilization of water resources should be improved as a whole.