The streamflow of major global rivers changes under the influences of climate change and human activities and varies greatly in different regions. The Yellow River has undergone a dramatic shift during the last six decades. Its streamflow gradually dwindled away and even dried-up severely in the late 20th century, but in recent years it has recovered and remains stable. Comprehensive understanding of the river streamflow change and its driving forces promotes effective water resource management within this complex human-natural system. Here, we develop a runoff identity attribution approach to analyze 61 years of streamflow observations from the Yellow River. We find that between the 1950s and the 1980s, human water consumption contributed more than 90% to streamflow reduction, but from the 1970s onwards, land cover change became the major factor to decrease streamflow. Since 2000, government management schemes have prevented streamflow from declining further and guarantee its stability. Based on the analysis framework we propose, persistent droughts, which are related to abrupt streamflow abatement, may be the most uncontrollable factor in the future. A more resilient management system should be therefore built to grapple with the expected increased frequency of such extreme climate events in the future.