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Water pollution in the Taihu Lake Basin has been the focus of attention in China and abroad for a long time, due to its position in the forefront of urban development in China. Based on data gathering and processing from 84 monitoring sections in this heavily polluted area, this study first analyzes spatial patterns of urbanization and the distribution of river water pollution, and then uses the GeoDa bivariate spatial autocorrelation model to investigate the spatial correlation between urbanization and river water pollution at the scale of township units. The results show that urbanization has adverse impacts on water pollution, and the influence varies in different levels of development areas. The urban township units have the highest level of urbanization and highest pollution, but the best water quality; the suburban units have lower level of urbanization, but higher pollution and worse water quality; however the rural units have the lowest level of urbanization and lowest pollution, mainly affected by upstream pollution, but worst water quality. Lastly, urban and rural planning committees, while actively promoting the process of development in the region, should gradually resolve the issue of pollution control lagging behind urban life and urban develop- ment, giving priority to construction of centralized sewage treatment facilities and associated pipeline network coverage in the rural areas and suburban areas.