Based on the velocity similarity theory, a test system for sediment wear flow around Francis turbine runner blades was established. The sediment wear test was carried out on the surface of Francis turbine runner blades with severe sediment wear before and after tungsten carbide spraying. The wear rate prediction model was established, and the effect of tungsten carbide spraying on the wear resistance of runner blades was analyzed. The results show that the serious wear position of Francis turbine runner blade by sediment appears in the head and tail, and the greater the load, the more serious the wear; after tungsten carbide spraying treatment, the sediment wear of runner blades is reduced by more than 90%, and the wear life is greatly improved. The sprayed tungsten carbide coating treatment is effective in reducing the effects of sediment wear.