Green development is the coordinated development of the economy, society and environment and has become a mainstream development model. This paper evaluates the green water resource utilization efficiency (GWRUE) of 38 regions in the four-city area in central China during 2010–2019 using a super-slacks-based measure (super-SBM) DEA model considering unexpected output. Then, the spatiotemporal variations in GWRUE are analyzed by the standard deviational ellipse method, and the geographical detector method is employed to reveal the dominant impacts and interaction impacts on GWRUE spatiotemporal variations. The results show that (1) from 2010 to 2019, the GWRUE in the four-city area in central China was low, and the difference among regions was obvious, showing a downward trend. (2) From 2010 to 2019, the spatial gravity center of GWRUE experienced a change process from northeast to southwest, and its moving speed showed a “waveform” rising trend. Moreover, the SDE range of each characteristic time point showed a decreasing trend, indicating that the spatial variations in GWRUE tended to be agglomerated. (3) From 2010 to 2019, the influence of each factor on the spatial variations in GWRUE was different each year. In addition, the two-way interactions between different influencing factors were mainly manifested as bivariate enhancement relationships and nonlinear enhancement relationships and were especially affected by multiple factors that produce a nonlinear enhancement interaction. This study can provide a practical basis for realizing water ecological civilization construction and high-quality development in the four-city area in central China.