To improve the wireless sensing image extraction technology of urban surface water environment, a regional FCM clustering method combined with water index was proposed in this paper. The normalized water index (NDWI) was obtained by calculating the fusion multispectral wireless sensing image. Through the combination with normalized water index, fuzzy clustering results were obtained by RFCM algorithm proposed in this paper. The optimal threshold was selected to defuzzify the fuzzy clustering results, and finally, the extraction results of urban surface water were obtained. The accuracy of the proposed algorithm was compared with that of the traditional surface water extraction algorithm. The experimental results showed that the size of different neighborhood regions affected the water extraction accuracy. In W city, the kappa coefficient of MFCM16 was 0.41% higher than that of MFCM8, and the overall classification accuracy of MFCM16 was 1.33% higher than that of MFCM. In G city area, the kappa coefficient of MFCM16 was 1.81% higher than that of MFCM8, and the overall classification accuracy of MFCM16 was 1.7% higher than that of MFCM. Comparing the RFCM algorithm with other algorithms, the RFCM algorithm obtained the best experimental results, to reduce the “salt-and-pepper phenomenon” effect.