Abstract Like many parts of the world, the Yellow River basin has problems associated with water scarcity, pollution, and flood risk. Analyses that focus only on the physical characteristics of these problems miss some of their most important social drivers. In this paper we identify some interlocking changes that have occurred as a consequence of economic reforms begun in China in 1978, and the implications of these changes for the Yellow River. The reforms have caused changes in the organisation of household production, increasing urbanisation and urban affluence, rapid industrialisation, and large scale spatial shifts in agricultural production. Rather than specific decisions it is these gradual changes that have affected the current status of the Yellow River and its basin. Our analysis suggests that at least some solutions to water problems in the Yellow River lie outside the basin, and beyond the realm of science or technology.