Based on the GEE cloud platform, Landsat 5/7/8 data, and the JRC dataset, the surface water area in the Yellow River Basin and typical lakes and reservoirs from 1986 to 2021 were extracted using the hybrid index algorithm, and the spatiotemporal distribution characteristics was analyzed. The contribution rate of climate factors and human activities to the permanent water area change in the Yellow River Basin was quantitatively evaluated using the cumulative slope change rate comparison method. The results showed that the producer accuracy of surface water extraction in the Yellow River Basin was 99.39%, the user accuracy was 91.51%, the overall accuracy was 94.22%, and the Kappa coefficient was 0.8785, indicating a good extraction effect. The surface water area of the Yellow River Basin showed an overall increasing trend from 1986 to 2021. The permanent water area of typical lakes and reservoirs, including Zhaling Lake, Eling Lake, Dongping Lake, Longyangxia Reservoir, and Xiaolangdi Reservoir, showed an increasing trend, while Hongjiannao and Liujiaxia Reservoirs showed a slight decreasing trend. Human activities are the dominant factor in the permanent water surface area changes in the Yellow River Basin. The contribution rate of precipitation gradually increases, while the contribution rates of temperature and solar radiation decrease, but the contribution rate of temperature is still around 20%.