Human activities and climate change are two critical driving forces of catchment hydrological processes, for which, streamflow and sediment load are the two main indicators. Changing trends and attribution analysis of streamflow and sediment load under changing environments are now the focus of hydrological and global change studies. The Loess Plateau (LP) of China is well known for its severe soil erosion and the heavy sediment load of the Yellow River that flows through it. To control soil erosion in the LP, large ecological restoration construction projects and several soil and water conservation measures have been implemented since the 1950s, which have resulted in extensive land use and vegetation cover changes. These extensive changes in land surface conditions in combination with climate change have dramatically altered the hydrological regime, including streamflow, sediment load, and flow-sediment relationships in the LP. The spatio-temporal variability of streamflow and sediment load, and the dominant mechanisms behind these changes are important issues in the development of strategies for sustainable land and water management in the LP. We reviewed previous studies that documented changes in streamflow, sediment load, and flow-sediment relationships to improve our understanding of these processes. The methods used to separate the impacts of human activities and climate change on streamflow and sediment load and the results obtained in these studies are summarized here. The influence of climate change, vegetation restoration, soil and water conservation measures, as well as catchment landscape patterns on driving changes in streamflow and sediment load are also discussed. Finally, the following further studies are proposed:1) Studying the spatio-temporal patterns in streamflow and sediment load evolution and quantifying the non-linear characteristics of flow-sediment relationships, 2) Demonstrating the effects and contributions of extreme events on streamflow and sediment load dynamics, 3) Conducting comprehensive analyses on the influence of multiple factors on streamflow and sediment load, 4) Developing a coupled rainfall-streamflow-sediment yield model that includes the dynamic characteristics of surface cover and climate change, with the aim of revealing feedback mechanisms between ecological restoration and the evolution of streamflow and sediment load, and 5) Predicting streamflow and sediment load dynamics under future scenarios of climate change, with the added effects of socio-economic development and ecological construction engineering; which is likely to provide suggestions for ecological treatment and water resource management in the LP, and regulation of water and sediment in the Yellow River.