Based on the disciplinary framework of soil and water conservation and its stage-wise development patterns, this paper reviews and summarizes the development process of soil and water conservation in the Yellow River Basin, analyzes the characteristics of different development stages, and synthesizes the progress achieved since the founding of the People’s Republic of China in terms of practice, theory, and technology. Based on years of investigation and research, it further examines key challenges and scientific issues hindering the high-quality development of soil and water conservation in the region. In addition, it identifies key scientific issues and critical technologies that need to be addressed, including the scientific connotation and disciplinary expansion of high-quality development of soil and water conservation, multi-dimensional service value assessment, landscape configuration and spatial zoning, carbon sink mechanisms and effectiveness evaluation, and the coordinated development of derivative industries. Finally, future directions for soil and water conservation in the Yellow River Basin are discussed.