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Understanding changes in human water utilization under the policy environment of the national top-down water unified allocation and regulation (TWAR) is crucial for promoting river health, sustainable resource utilization, and high-quality socioeconomic development along the whole Yellow River, a congenitally water-deficient river in China. This study assessed the TWAR policy effects on the total/sectoral/per capita water uses using the canonical difference-in-difference (DID) model, synthetic control method (SCM), and generalized synthetic control method (GSCM). The net effects of TWAR were assumed to be spatially heterogeneous and associated with variations in water-conserving efficiency, described by two indicators: water-conserving irrigation (WCI) and industrial recycled water (IRW). The suitable threshold intervals of WCI and IRW for benefiting decelerating water utilization were analyzed using a linear mediating effect (ME) model and panel smoothing transformation regression (PSTR) model, to explain the rebound effect in water use under the impact of the prevailing TWAR. The results show that TWAR initially had sustained positive effects on curbing water use growth, with the highest contribution to per capita agricultural water use in the lower section and high-quota region of the Yellow River Basin, but these effects decreased after a decade. Only when the WCI shifted within the threshold interval [0.283, 0.771] and the IRW did not exceed 0.962 could TWAR restrain water use. Emphasizing the conservation-oriented improvement of water use efficiency may necessitate extra attention to regions where water-conserving practices already reach high levels beyond the maximum WCI or IRW thresholds. These regions might be inclined to overutilize saved water to boost economic benefits and thereby potentially exacerbate the undesirable rebound effect from new uncontrolled water extraction. • TWAR policy effects on total/sectoral/per capita water uses were assessed. • Three quasi-natural experimental methods were employed: DID, SCM, and GSCM. • Water use initially slowed by TWAR may rebound after decadal periods. • TWAR's causality showed heterogeneity due to sectoral water-conserving efficiency. • Inhibiting role on water use was functional within suitable efficiency thresholds. [ABSTRACT FROM AUTHOR]