Alluvial-lacustrine deposits are important carriers for studying paleo-hydrological information and the evolution of paleo-environments. In this study, a total of 6 optically stimulated luminescence (OSL) samples from 2 profiles in the lower and middle reaches of the Hutubi River in the North Tianshan Mountains were dated, and a comprehensive analysis was conducted by integrating sedimentary structures, grain sizes, and magnetic susceptibility characteristics to explore the sedimentary environment patterns and regional evolution processes during the Mid to late Holocene. The results revealed the following findings: (1) The OSL signal of quartz samples indicates the predominance of fast components, allowing reliable dating of regional fluvial sediments using the appropriate condition-tested coarse-grained quartz single-aliquot regenerative dose (SAR) protocol within the 90–125 μm range. (2) Analysis of sedimentary structures, grain sizes, and magnetic susceptibility characteristics reveals lithofacies of heterotopic synchronous or homotopic asynchronous in exposed profiles, with predominantly poorly sorted fine and very fine sand. Magnetic susceptibility is primarily controlled by the content of magnetic minerals in the coarse particles, while also being influenced by the combined effects of provenance input and depositional environment, indicating a complex regional sedimentary environment influenced by variable hydrodynamic conditions driven by fluvial processes. (3) Based on OSL dating results and the analysis of various environmental proxy indicators, it is determined that the climatic environment in the Middle and Late-Holocene in the downstream areas of the northern piedmonts of the Tianshan Mountains demonstrates a fluctuating pattern of wet and dry alternations. The sedimentary environment shifted from a stable state in the Mid-Holocene to an unstable state in the Late-Holocene. The intermittent appearance of wet records may be associated with increased river activity caused presumably by the release of high-altitude ice due to rising temperatures and warming conditions.