Important factors affecting sustainable regional development are the bearing capacity of water resources as well as sustainable utilization and water management. In an attempt to forecast social and economic development, the authors have calculated the volume of water demand for industrial, agricultural, and residential uses and the balance between water supply and demand in every city in the Pearl River Delta Economic Zone—one of most dynamic economic areas in China as well as the world. New concepts and calculation methods on the damage coefficient of water resources, the Index of Theoretical Bearing Capacity of Water Resources (i.e., “absolute bearing capacity”) and the Index of Practical Bearing Capacity of Water Resources (i.e., “relative bearing capacity”) are proposed by the authors. Trends of bearing capacity of water resources of each city are evaluated. The three main causes of water shortage—excessive water consumption in industry, insufficient water supply, and increase in water pollution—are examined. Some suggestions for sustainable utilization of water resources are proposed.