Surface water quality deterioration is a serious problem in many rapidly urbanizing catchments in developing countries. There is currently a lack of studies that quantify water quality variation (deterioration or otherwise) due to both socio-economic and infrastructure development in a catchment. This paper investigates the causes of water quality changes over the rapid urbanization period of 1985-2009 in the Shenzhen River catchment, China and examines the changes in relation to infrastructure development and socio-economic policies. The results indicate that the water quality deteriorated rapidly during the earlier urbanization stages before gradually improving over recent years, and that rapid increases in domestic discharge were the major causes of water quality deterioration. Although construction of additional wastewater infrastructure can significantly improve water quality, it was unable to dispose all of the wastewater in the catchment. However, it was found that socio-economic measures can significantly improve water quality by decreasing pollutant load per gross regional production (GRP) or increasing labor productivity. Our findings suggest that sustainable development during urbanization is possible, provided that: (1) the wastewater infrastructure should be constructed timely and revitalized regularly in line with urbanization, and wastewater treatment facilities should be OPEN ACCESS Sustainability 2014, 6 7434 upgraded to improve their nitrogen and phosphorus removal efficiencies; (2) administrative regulation policies, economic incentives and financial policies should be implemented to encourage industries to prevent or reduce the pollution at the source; (3) the environmental awareness and education level of local population should be increased; (4) planners from various sectors should consult each other and adapt an integrated planning approach for socio-economic and wastewater infrastructure development.