Climate change and human activities exert significant impacts on runoff generation and convergence mechanisms. Understanding the evolution mechanisms and driving forces of runoff is crucial for the sustainable development of water resources. This study is based on the runoff data of the Huayuankou (HYK), Jiahetan (JHT), and Gaocun (GC) stations in the lower reaches of the Yellow River from 1951 to 2019. The objectives are to identify and quantify the hydrological pattern and its driving mechanism of the three stations by the Mann–Kendall test, cumulative deviation method, wavelet analysis, the IHA-RVA method, SCRCO method, and the Budyko method. Our study revealed that the runoff disturbance points at all three stations occurred in 1985. During the two periods before and after the disturbance, the trends and periodicities within the year exhibited high consistency, showing an overall downward trend, with runoff increasing in October and decreasing in June and the primary cycles being 5 and 7 years. All three stations experienced high-degree changes in their hydrological situations, with the high-degree change occupying the largest proportion. At the HYK, JHT, and GC stations, human activities accounted for 66.05%, 71.94%, and 74.38% of runoff changes, respectively. Furthermore, we verified the attribution conclusion of runoff at HYK using the Budyko model, confirming that human activities are the primary factor influencing runoff. Finally, we explored the interactive relationships along the spatial trajectory of runoff at the three stations, analyzed 32 hydrological indicators, and detailed the land use changes in the Yellow River Basin. Our research findings complement the understanding of hydrological change mechanisms in the lower reaches of the Yellow River Basin and provide a scientific basis for future water resource management and flood prevention measures.