To address trajectory-tracking degradation of unmanned surface vehicles (USVs) in constrained waters caused by model uncertainty, strong environmental disturbances, and actuator limitations, this paper proposes a robust disturbance-observer-based optimization model predictive control method. First, a nonlinear tracking error model is established for a 3-DOF USV by incorporating environmental loads, parametric perturbations, and unmodeled dynamics into the kinematic and dynamic equations. Based on this model, a prediction model suitable for model predictive control is derived through linearization and discretization. Then, to estimate complex unknown disturbances online, a robust disturbance observer integrating a radial basis function neural network (RBFNN) with an adaptive sliding-mode mechanism is developed, enabling real-time approximation and compensation of lumped disturbances in the surge and yaw channels. Furthermore, to overcome actuator saturation caused by the direct superposition of feedforward compensation and feedback control in conventional composite strategies, a dynamic constraint reconstruction mechanism is introduced. By feeding the observer-generated compensation signal back into the MPC optimizer, the feasible control region is updated online so that the total control input satisfies both magnitude and rate constraints of the propulsion system. Theoretical analysis based on Lyapunov theory proves the uniform ultimate boundedness of the observation errors and neural-network weight estimation errors, while input-to-state stability theory is employed to establish closed-loop stability. Comparative simulations under sinusoidal trajectories, time-varying curvature paths, and large-maneuver turning conditions demonstrate that the proposed method significantly improves tracking accuracy, disturbance rejection capability, and control feasibility under severe disturbances and parameter mismatch.