Surface runoff change is significantly influenced by both human activities and climate change. Decoupling their respective contributions to runoff change represents a critical frontier in hydrological research and a pressing challenge for water resource management. This study focuses on the Dawen River Basin, a strategic area for ecological conservation and high-quality development in the lower Yellow River region. By integrating three methodological approaches—empirical models (Precipitation–Runoff Double Mass Curve), conceptual models (elasticity coefficient methods), and hydrological models (Soil and Water Assessment Tool, SWAT)—we systematically quantify the impacts of climate change and human activities on runoff change. A correlation analysis was first applied to screen independent runoff drivers and basin characteristic factors, followed by a random forest algorithm to rank their relative importance. This process informed the establishment of a comprehensive framework for runoff attribution analysis. Results demonstrate that hydrological modeling (SWAT) is the most appropriate method for the Dawen River Basin, revealing human activities as the dominant driver of runoff changes, accounting for 70% to 82%. These findings provide critical insights for guiding sustainable water resource planning and management in anthropogenically stressed basins under a changing environment.