Abstract: The hydrologic regime has undergone significant and long-term adjustment in the Hanjiang River basin, which is the water head site of Central Line Project of South-to-North Water Diversion. It is key to explore hydrometeorological trends and driving forces for sustainable utilization of water resources and formulation of reasonable water resources management policies. In this paper, the double mass curve method, the accumulative anomaly method and the Mann-Kendall method were used to analyse the hydrometeorological data for the nearly 50 years in the Hanjiang River basin. Results indicate that the annual rainfall in the upper and lower reaches of Hanjiang River shows an increasing trend, but shows a decreasing trend in the middle reaches. Annual average temperature and evaporation increase in the whole basin. From 1965 to 2016, water resources could satisfy the needs for human activities in the upper reaches of the Hanjiang River, while failing those in the middle and lower reaches of the Hanjiang River, despite steady rise in demand since 1977. Two inflection points, 1990 and 2010, were identified, according to which the based period, aberrant period Ⅰ and Ⅱ were divided. Utilizing the slope change ratio of the fitted beeline between year and accumulative quantity, the contribution rates regarding the influence of the fluctuation in climate and human activities on the upper reaches and whole basin is 26.1%, 73.9%, 33.8%, 66.2% in aberrant period Ⅰ, and 19.3%, 80.7%, 43.7%, 56.3% in aberrant period Ⅱ, respectively. The human activities are the main driving force of runoff change, and the effect of that on runoff in the upper reaches of the Hanjiang River is greater than that in the whole basin. In aberrant period Ⅱ, the influence of human activities on the runoff in the upper reaches of the Hanjiang River increase by 6.8%, while that in the whole river basin decrease by 9.9%.