Abstract: The World Heritage Irrigation Structure has the dual attributes of irrigation engineering and cultural heritage. Based on 19 projects selected in the World Heritage Irrigation Structures in China, this paper summarizes the characteristics and values of the World Heritage Irrigation Structures, analyzes the current situation and existing problems of protection and utilization, and discusses the protection strategies from the perspective of sustainable development. The research results show that China’s Heritage Irrigation Structures are characterized by rich resources, diverse types, a long history, outstanding benefits and wide distribution. All related regions have made positive contributions to the development, protection and utilization of Heritage Irrigation Structure resources. The basic principle of emphasizing both irrigation engineering and cultural heritage can be included in the protection and utilization process. Some measures can also be used, e.g. a unified management mechanism, overall planning and multiple protection, research on theoretical basis and key technologies, broadening the channels of display and publicity, and enhancing the awareness of comprehensive protection.