Wetlands are the most threatened ecosystem in China, and wetland conservation is a national priority because of their importance for water security, flood mitigation, and biodiversity conservation. A goal has been established for the Beijing-Tianjin-Hebei Region (BTH) to recover 340 km2 of wetlands by 2020. To guide restoration and protection efforts, policymakers need information on the trends of wetland loss, conversion of wetlands, and their associated human drivers. The main drivers of changes in different wetland types in the BTH were identified and quantified from 2000 to 2015. In 2015, there was 6264.07 km2 less wetland area than in 2000, with the remaining wetlands primarily located in Hebei and Tianjin. Reservoirs/ponds were the most abundant wetland type, followed by herbaceous swamps, rivers, canals and channels, and then lakes as the least represented. There were continuous losses of wetlands from 2000 to 2015, with marked decreases for rivers (30.48%), channels/canals (23.30%), and herbaceous swamps (16.12%). However, there was an increase in the area of lakes and reservoirs/ponds, with increases of 54.96% and 3.47%, respectively. The largest changes in natural wetlands were due to agricultural production followed by artificialization and grassland expansion. The driving forces of the observed changes were specific to each local region. According to an aggregated boosted trees (ABT) analysis, gross farm production, total aquatic products, and irrigated area were the top three drivers of the decrease in natural wetlands, which agreed with the main patterns of change in the BTH. The purpose of this study was to provide guidance for policy makers working to meet the 2020 BTH wetland recovery target. Recommendations were provided at the provincial level, including water transfers across provincial boundaries, the control of agricultural expansion, exploration of species-specific irrigation deficits, a reduction in the artificialization of land surfaces, the development of a sustainable intensified aquaculture model, and the promotion of awareness of wetland importance among local people.