Tight sandstone reservoirs are characterized by complex pore structures and ultra-low permeability, resulting in low recovery efficiency when relying solely on formation elastic energy. Consequently, water flooding is commonly employed for reservoir development. To investigate the two-phase flow behavior and pressure response during water flooding in tight sandstone reservoirs, long-core displacement experiments were conducted using outcrop tight sandstone cores. Thirteen pressure monitoring points were distributed along the core to continuously record the pressure response during water flooding, while cumulative oil and water production were measured to characterize the displacement performance. The temporal evolution of pressure and productivity index was systematically analyzed, and numerical simulation was further performed to interpret the relationship between pressure variations and water-front propagation. The results show that the cumulative oil production reached 50.95 mL, corresponding to a final oil recovery of 31.26%. No water production was observed during the initial stage of displacement, and water production began at approximately 8000 min, after which both water production and oil production gradually approached stable levels. The pressures at different monitoring locations exhibited a characteristic increase–decrease–increase pattern during the displacement process, whereas the productivity index decreased progressively before approaching a relatively stable value. Based on the experimental observations and numerical simulation results, the pressure response characteristics were closely associated with the propagation of the water front, with distinct pressure inflection points observed at different locations along the core. The mechanisms underlying pressure fluctuations and the decline in productivity index were analyzed from two perspectives: the extensive formation of dispersed phases and the dynamic evolution of interfacial flow resistance. These results provide experimental and numerical evidence for understanding pressure propagation and productivity evolution during water flooding in tight sandstone reservoirs.