The Heihe River Basin (HRB) is the second largest inland river basin in the northwestern arid and semi-arid regions of China. Recent Comprehensive Control Projects in the HRB were implemented beginning in 2001. The ecological and hy- drological benefits of this effort were evaluated by analyzing the resulting changes in the vegetation cover and groundwater levels. Ten-year time series VEGETATION data were used to monitor the changes in vegetation cover in the HRB. The driving factors were analyzed for different regions with increasing or decreasing vegetation cover. Increases in mountainous precipitation and runoff resulted in increasing vegetation cover. In some regions in the middle and downstream portions of the HRB, decreases in vegetation cover exhibited a strong relationship with changes in groundwater levels. Constructive sugges- tions are provided for local governments based on the analysis results.