Although we are in an era of enormous global commitments to ecological restoration (the UN Decade on ER; the Bonn Challenge), little attention has been paid to the importance of sustained commitment to individual restoration initiatives and few resources have been dedicated to monitoring, especially the long-term and broad-scale evaluations that would allow us to understand how basin-scale restoration can result in complex spatiotemporal patterns. Remote sensing offers a powerful tool for evaluating restoration initiatives focused on water management in arid regions, where changes in vegetation growth can be tracked visually with measures like the generalized difference vegetation index (GDVI). In this paper, we evaluate the Comprehensive Treatment Program of the Shiyang River Basin (CTSRB), a landscape restoration initiative in China’s northwest, using a widely available remote sensing tool, showing how it can reveal the causes of fluctuating changes in restoration success. We focus on spatiotemporal variation, studying a time series from 2001 to 2020 using regression, trend, and stability analyses for six different divisions of the study region (the study area as a whole, the irrigated areas, the periphery of the irrigated regions, and the districts of Ba, Quanshan, and Hu) to evaluate the effects of the restoration initiative. The study period was divided into four equal-length phases based on the implementation timeline of the CTSRB, which includes one pre- and post-intervention interval and two stages of the CTSRB. We found that the CTSRB has played a positive role in the restoration of vegetation in the Minqin Basin, especially desert vegetation. However, the positive effects were not obvious in the first CTSRB period, which was characterized by a decline in vegetation growth likely caused by the strategy of “close the pumping-wells, transform the land”, which reversed a greening trend caused by the unsustainable irrigation of wasteland prior to the project’s initiation. During the second phase of the CTSRB, vegetation in the regions of “transform the land” gradually improved, and the growth of desert vegetation gradually improved and expanded as a result of more water flowing out of agricultural zones. The rate of vegetation recovery slowed down during the final phase of the CTSRB, and some areas even experienced a decline in the GDVI. Overall, our findings show that the CTSRB, by integrating water management and allowing for uninterrupted ecological restoration, drove complex regional changes in the GDVI, including successful restoration of desert vegetation. The spatiotemporal variable we observed underscores the importance of long-term commitment to arid land restoration initiatives and the importance of even longer-term monitoring using tools like remote sensing.