Surface waters are very important for society, as they are a source of potable water, as well a water supply for agricultural, industrial and recreational purposes. This paper presents changes in the quality of the water in the Utrata River, along its entire length, as a function of the catchment area’s land use. Water-quality measurements were carried out once a month for a total period of one year (April 2019–March 2020) at 24 measurement points. The concentrations of the following compounds were measured: total phosphorus, ammonia nitrogen and nitrate nitrogen, dissolved oxygen, and chemical oxygen demand. The results were compared with the limit values specified in the Regulation of the Minister of Maritime Economy and Inland Navigation. In order to determine the impact of land use on water quality in the Utrata River, principal component analyses (PCA) were conducted. The research demonstrated a considerably negative impact of agricultural land use and the presence of urban areas on the water quality of the Utrata River, with elevated concentrations of total phosphorus, ammonia nitrogen, nitrate nitrogen and COD, and decreasing concentrations of dissolved oxygen. The presented results point to the need for effective strategies to mitigate the adverse impact of agriculture and urbanisation on the environment and surface waters.