Industrial water saving is an objective requirement for the high-quality development of the Yellow River Basin, as water resource is the largest rigid constraint. In this study, water resources input-output model, structural decomposition analysis (SDA) and structural path analysis (SPA) were constructed to decompose the driving factors of total water use in typical water-deficient provinces (Ningxia, Shanxi, and Henan) in China’s Yellow River Basin, to calculate their water use at each production stage and identify their key water-saving pathways. The results were as follows: (i) Water intensity had the most obvious impact on total water saving, resulting in efficiency improvements of 81.39%, 9.21%, and 78.45% for each province, respectively. The next factor was the final demand structure, which suppressed total water-saving efforts by 24.23%, 11.52%, and 113.12% in the respective provinces. (ii) The key water-saving paths in the typical water-deficient provinces of the Yellow River Basin were primarily centered around Sector 1. (iii) Water intensity had a strong water-saving effect on the key paths in the three provinces, with contribution rates of 100.42%, 59.02%, and 42.34% for Ningxia, Henan, and Shanxi, respectively. Final demand also contributed to water-saving in the key paths of Shanxi and Henan, with contribution rates of 35.06% and 28.23%, respectively. However, it inhibited water-saving efforts in the key paths of Ningxia, reducing it by 8.64%. Policy measures should be tailored to local conditions.