The Jiziwan region in the Yellow River basin serves as the strategic core of China's modern coal chemical industry; however, sustainable development of the region is severely constrained by limited water resources. This study considers multiple factors, including regional macro socioeconomic development trends, national and regional energy strategies and plans, as well as technological and market development trends in the modern coal chemical industry. We adopt a bottom-up, product-based water demand estimation method to project medium- and long-term water use trends in the region and identify key challenges to the sustainable development of the regional coal chemical industry. Our findings highlight three major constraints: an inherent shortage of water resources; bottlenecks in water-saving technologies and under-utilization of unconventional water sources; and insufficient water supply capacity to meet the demands of future industrial expansion. In response, we propose strategic pathways for water-adaptive development: expanding the diversity of water supply sources, enhancing the efficiency and effectiveness of water resource management, and advancing technological innovation in the modern coal chemical sector.