As an essential grain production base in China, environmental changes in the Yellow River Basin directly affect the sustainable development of the basin's economy. The upper and middle reaches are essential for ecological protection and development of the basin in central and western China, and play a key role in maintaining environmental security in northern China. However, frequent drought events seriously threaten the ecological balance and socio-economic development. In this study, we used the self-calibrated Palmer drought severity index and standardized precipitation evaporation index to characterize meteorological drought, and the soil moisture deficit index to characterize agricultural drought. Linear regression, abrupt change point detection, and maximum correlation coefficient methods were used to character the vegetation dynamics and drought evolution characteristics of different geographical divisions in the upper and middle reaches of the Yellow River and further explored the vegetation response to regional drought evolution. Our results showed that: 1) the basin underwent an abrupt change in vegetation evolution and wet-dry transition characteristics in 2006, transitioning from a drier period (1982-2005) to a wetter period (2006-2015).; 2) after 2006, the intensity of reforestation decreased, while the annual average NDVI increased from 0.006/10a to 0.021/10a, emphasizing the important role of the warming-wetting process, in addition to anthropogenic activities, in accelerating the greening of the vegetation in the upper and middle reaches of the Yellow River; 3) there was spatial heterogeneity in the response of vegetation to different drought types. In the western of the Inner Mongolia Plateau, the northern of the Qinghai-Xizang Plateau, and the northern of the Loess Plateau, the vegetation was more affected by drought, and the NDVI showed a positive correlation with the drought index. Compared with agricultural droughts, meteorological droughts had a larger impact range and their impact was further enhanced after 2006. This study can provide a theoretical basis and data support for the ecologically sustainable development of the Yellow River basin.