In order to continuously promote water conservation efforts to alleviate the pressure of water diversion, water footprint (WF) is used as an effective tool to measure water utilization in the water-receiving areas of the Middle Route and Eastern Route of the South-to-North Water Diversion Project (SNWDP). The tempo-spatial variations of WF and spatial equilibrium of water footprint intensity (WFI) in the study area are quantified using the Mann–Kandle trend test, Sen’s slope, and Dagum Gini coefficient decomposition method for the years of 2005–2020. The results show that WF has a significant decreasing trend (Sen’s slop < 0, significant level < 0.05) in 17 cities in the study area, whereas WF shows a significant increasing trend (Sen’s slop > 0, significant level < 0.05) in 10 cities. Cities in the water-receiving areas are categorized into three types based on the contribution of the water utilization sector to changes in WF as follows: agriculture water-dominated city (AD), domestic and ecological water-dominated city (DED), and virtual water trade-dominated city (VWTD). Accordingly, targeted water conservation recommendations are made for these three kinds of cities, and it is suggested that AD, DED, and VWTD cities need to focus on advanced irrigation technologies, water reuse, and trade restructuring, respectively. The overall Gini coefficient of WFI fluctuates between 0.219 and 0.267 in the water-receiving areas of the Middle Route, which is dominated by the differences in city level. However, it fluctuates between 0.412 and 0.278 in the water-receiving areas of the Eastern Route, which is dominated by the differences in provincial level. Accordingly, water conservation hotspots are determined at the city level in the Middle Route and at the provincial level in the Eastern Route with different water management policies. These results provide a scientific support for water conservation management in the water-receiving areas of the SNWDP, as well as a methodological reference for the tempo-spatial characteristics of WF and their implications for water conservation.