Sudden floods in the medium and small watershed by a sudden rainstorm and locally heavy rainfall often lead to flash floods. Therefore, it is of practical and theoretical significance to explore appropriate flood forecasting model for medium and small watersheds for flood control and disaster reduction in the loess region under the condition of underlying surface changes. This paper took the Gedong basin in the loess region of western Shanxi as the research area, analyzing the underlying surface and floods characteristics. The underlying surface change was divided into three periods (HSP1, HSP2, HSP3), and the floods were divided into three grades (great, moderate, small). The paper applied K Nearest Neighbor method and Fireworks Algorithm to improve the Extreme Learning Machine model (KNN-FWA-ELM) and proposed KNN-FWA-ELM hybrid flood forecasting model, which was further applied to flood forecasting of different underlying surface conditions and flood grades. Results demonstrated that KNN-FWA-ELM model had better simulation performance and higher simulation accuracy than the ELM model for flood forecasting, and the qualified rate was 17.39% higher than the ELM model. KNN-FWA-ELM model was superior to the ELM model in three periods and the simulation performance of three flood grades, and the simulation performance of KNN-FWA-ELM model was better in HSP1 stage floods and great floods.