Abrupt climate fluctuations between 4.2 and 3.5 ka BP, and in particular the 4.2 ka BP event, exerted a profound impact on the global ancient civilizations. However, hydroclimatic conditions within the Asian Summer Monsoon (ASM) regions during this event remain uncertain. Here we report a multi-proxy analysis of a sediment core obtained from Dayeze Lake in the lower reaches of the Yellow River in monsoonal China, to elucidate the hydroclimatic variabilities over the past 4.2 ka. Core intervals (4.2–3.5, 1.1–0.6 cal ka BP) containing high levels of sand fraction, low-frequency magnetic susceptibility and zirconium, and low levels of organic matter and calcium oxide, reflect outburst floods from the Yellow River. This is supported by the widespread fluvial deposits and slackwater deposits preserved in archaeological sites and loess-paleosol profiles from the middle and lower reaches of the Yellow River. In contrast, various climate records, such as lake level, pollen, and tree ring data, from the marginal regions of the ASM reflect widespread droughts during the same time period. This finding highlights the significant spatial heterogeneity of hydroclimate within ASM regions associated with the 4.2 ka BP event, which may be related to migrations of the monsoonal rain belt and the West Pacific subtropical high, as well as frequent El Niño–Southern Oscillation events. Referring to archaeological data, we conclude that the decline and collapse of Chinese Neolithic cultures were related to a pattern of droughts in the marginal regions of the ASM and floods in the middle and lower reaches of the Yellow River.