In this research, monthly hydrological and daily meteorological data were collected across China for the period 1956–2012. Modified Mann–Kendall tests, double mass curve analysis, and correlation statistics were performed to identify the long-term trends and interrelation of the hydrometeorological variables and to examine the influencing factors of streamflow and sediment. The results are as follows: (1) In the last 60 years, the streamflow in northern China has shown different decreasing trends. For the southern rivers, the streamflow presented severe fluctuations, but the declining trend was insignificant. For the streamflow in western China, an increasing trend was shown. (2) In the northern rivers, the streamflow was jointly controlled by the East Asian monsoon and westerlies. In the southern rivers, the runoff was mainly influenced by the Tibet–Qinghai monsoon, the South Asian monsoon, and westerlies. (3) Sediment loads in the LCRB (Lancang River Basin) and YZRB (Yarlung Zangbo River Basin) did not present significant change trends, although other rivers showed different degrees of gradual reduction, particularly in the 2000s. (4) Underlying surface and precipitation changes jointly influenced the streamflow in eastern rivers. The water consumption for industrial and residential purposes, soil and water conservation engineering, hydraulic engineering, and underlying surface changes induced by other factors were the main causes of streamflow and sediment reduction.
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