Abstract: Water balance is a principal material balance in the world. It is closely connected with the normal operation of water cycle system, the stable evolution of the ecosystem and the sustainable utilization of water resources. However, existing discussion on the basic concept of water balance and the methodology of forming appropriate water balance is rather scarce. Based on the characteristics of natural-social coupled water cycle, regional water balance is deeply illustrated including its basic concept, multiple connotations and main traits. Meanwhile, the main natural and anthropological factors influencing the state of water balance is expounded. Then, the definition of healthy water balance is proposed. Furthermore, comprehensive criterions for regional healthy water balance is elaborated. A bilateral path to healthy water balance realization is also proposed, which combines carrying capacity improvement and pressure reduction of the water cycle system. Healthy water balance provides a vital instruction for implementing the principal of water-based development in the planning and practice of territory space development.