In the West African Sahel, two paradoxical hydrological behaviors have occurred during the last five decades. The first paradox was observed during the 1968–1990s ‘Great Drought’ period, during which runoff significantly increased. The second paradox appeared during the subsequent period of rainfall recovery (i.e., since the 1990s), during which the runoff coefficient continued to increase despite the general re-greening of the Sahel. This paper reviews and synthesizes the literature on the drivers of these paradoxical behaviors, focusing on recent works in the West African Sahelo/Sudanian strip, and upscaling the hydrological processes through an analysis of recent data from two representative areas of this region. This paper helps better determine the respective roles played by Land Use/Land Cover Changes (LULCC), the evolution of rainfall intensity and the occurrence of extreme rainfall events in these hydrological paradoxes. Both the literature review and recent data converge in indicating that the first Sahelian hydrological paradox was mostly driven by LULCC, while the second paradox has been caused by both LULCC and climate evolution, mainly the recent increase in rainfall intensity.