Tight sandstone gas reservoirs generally contain water. Studying the impact of water content on the permeability mechanism of tight gas reservoirs is of positive significance for the rational development of gas reservoirs. Selected cores from a tight sandstone gas reservoir in the Ordos Basin were used to establish the variation in its seepage mechanism under different water saturations. The experimental results show that the gas slip factor in tight water-bearing gas reservoirs decreases as the water saturation increases. The stress sensitivity coefficient and the threshold pressure gradient (TPG) increase with increasing water saturation, characterizing the relationships between stress sensitivity coefficients, TPG, permeability, and water saturation. As the water saturation gradually increases, the relative gas phase permeability of tight sandstone gas reservoirs will sharply decrease. When the water saturation exceeds 80%, the gas phase permeability becomes almost zero, resulting in gas almost ceasing to flow. Through the analysis of experimental results, we defined high-water-cut tight sandstone gas reservoirs and analyzed the permeability characteristics of high-water-cut tight sandstone gas reservoirs in different regions. Combining stress sensitivity coefficients and the TPG with permeability and water saturation relationships, we established a zoning productivity calculation method of fractured horizontal wells in high-water-cut tight sandstone gas reservoirs under complex seepage conditions and validated the practicality of the model through example calculations.