As a developing country with insufficient water resources, China’s water environment management and performance evaluation have important research value. The three provinces (Henan, Hubei, and Hunan) in central China with typical significance in geographical location and water resources governance were selected as research objects in this paper. Based on the principal component analysis (PCA) method and the pressure-state-response (PSR) model, a comprehensive evaluation system for the water environment in those three provinces during 2011–2017 was established in this paper. The evaluation results show that: (1) The water environment management and performance evaluation of the three provinces in central China were generally poor in 2011–2012, but the overall trend was rising; (2) in 2013–2014, the situation was improved compared to the previous two years, but needed further enhancement; (3) in 2015–2017, the water environment management and performance of the three provinces showed significant improvement. Among them, the Hubei Province had the highest water environment evaluation value (1.692), and the Henan Province had the most significant progress (from 0.043 to 1.671). The contributions of this paper are: (1) The comprehensive evaluation model based on PCA and the PSR model was constructed to analyze the sustainable development of water environment in central China; (2) the performance evaluation system for water environment management, which could comprehensively evaluate the performance of water environment treatment and effectively reveal the correlation between various indicators, was established. The principal factors in water environment management can be obtained by this evaluation system. Based on the analysis of the reasons underlying the above changes, the corresponding policy recommendations for improving water environment management and performance in central China were suggested in order to provide a reference for further improvement of water environment management in developing countries.