Monitoring the status and dynamics of desertification is one of the most important parts of combating desertification. In this study, 30m high-resolution information on land desertification and restoration in the HRB was extracted from the land cover database. The results indicate that land desertification coexists with land restoration in the HRB. At different periods, the area of land restoration is much larger than the area of land desertification in the HRB, and the HRB has been in a process of land restoration. Upstream of the HRB, there is a continuing trend of increasing land desertification associated with overgrazing in a context where climate change favors desertification reversal. In the middle and lower reaches, although both climate variability and human activities favor land desertification, the process of land desertification in the middle and lower reaches is still being reversed and land restoration dominates. The implementation of the Eco-Environmental Protection Project and desertification control measures, especially the EWDP, is contributing to the reversal of desertification in the middle and lower reaches of the HRB. However, the EWDP has indirectly led to the lowering of the water table in the middle reaches, resulting in local vegetation degradation. Therefore, there is therefore an urgent need to transform the economic structure of the middle reaches to cope with water scarcity and land desertification.