Henan Province, a significant cultural heritage province in China, has abundant tangible cultural heritage resources distributed across the region. Watersheds are the fundamental geographical units that have consistently supported human production and subsistence activities from ancient times to the present. Analyzing the spatial distribution characteristics and influencing factors of tangible cultural heritage resources of the watersheds in Henan Province is of great importance for its macro-level preservation, value promotion, and sustainable development. This research focuses on the 421 major historical and cultural sites protected at the national level in Henan Province, utilizing GIS spatial analysis techniques such as kernel density estimation, nearest neighbor index, Thiessen polygons, spatial auto-correlation analysis, and geographically weighted regression to investigate the spatial distribution characteristics and influencing factors of tangible cultural heritage across different watersheds in the province. The results indicate the following: (1) The cultural heritage sites in Henan Province exhibit an overall clustered distribution. Within specific watersheds, such as the Jindihe River, Huaihe River, and Baihe River, the cultural heritage distribution is relatively sparse, displaying a random distribution pattern. (2) The cultural heritage distribution forms two high-density centers and one high-density distribution belt, exhibiting a tendency to align along lower-grade rivers. (3) The distribution of cultural heritage shows significant spatial auto-correlation, with high-value areas (hotspots) concentrated at the watershed intersections of the Yiluohe River, Weihe River, and Yinghe River. (4) Elevation, precipitation, GDP from the tertiary sector, museum density, and proximity to the nearest historical and cultural cities are the primary factors influencing the spatial differentiation of cultural heritage within each watershed. Moreover, there is significant spatial heterogeneity between different watersheds. Lastly, specific strategies for the sustainable preservation and utilization of cultural heritage in Henan Province are proposed, including differentiated preservation approaches, strengthening the preservation of water-related cultural heritage, promoting sustainable cultural tourism development, and establishing mechanisms for cross-regional cooperation.