To conduct a comprehensive investigation into the spatiotemporal variability characteristics of precipitation within the middle Yellow River basin, elucidate the interrelationships between precipitation and key environmental factors, and assess the spatial heterogeneity of precipitation patterns. The Mann-Kendall test, Pettitt test, and Morlet wavelet analysis were employed to investigate the temporal characteristics of a 67-year (1956-2022) annual precipitation series derived from 15 monitoring stations in the Middle Yellow River Basin. The nonparametric Kruskal-Wallis H test was used to evaluate whether precipitation exhibited significant differences across these stations. Additionally, spatial autocorrelation analysis using Moran’s I was conducted based on multi-year mean annual precipitation data from 230 counties/districts within the same region, to examine the clustering patterns of precipitation distribution. The results indicated that increasing precipitation trends were detected in the northern and southwestern portions of the Middle Yellow River Basin, while the remaining areas exhibited a predominant decreasing trend, though all trends were statistically non-significant (α = 0.05). Statistically significant trend abrupt change points in the time series primarily occurred in 1978, 2003, and 2020 at some stations. The Pettitt test indicated that the mean annual precipitation across the 15 stations showed no significant change point over time. The wavelet analysis revealed three predominant temporal scales in the study area: 5-10, 15-30, and 30-55 years, while the wavelet variance plot identified three dominant periodicities centered at approximately 10, 44, and 56 years. Heterogeneity testing demonstrated that annual precipitation differences among the 15 stations increased with latitudinal distance along the north-south transect. The global Moran’s I value of 0.5533 (p<0.05) indicated significant positive spatial autocorrelation in annual precipitation across the Middle Yellow River Basin. Local Moran’s I analysis revealed distinct spatial clustering patterns: high-high clusters were predominantly concentrated in the southern region, while low-low clusters aggregated in the northern and partial southwestern areas, with no significant spatial autocorrelation observed in the central zone. Although vegetation restoration in the Middle Yellow River Basin has reduced erosion, more water resources have been consumed in the process due to no significant changes in precipitation, which may increase the regional water ecological security risks. These findings provide important theoretical references for optimizing water resource allocation in the Yellow River Basin, supporting ecological conservation and sustainable development.