Precipitation is very important to the formation of runoff, and studying of runoff variation and its response to precipitation has practical significance to sustainable utilization of water resources. The study used Mann-Kendall test, anomaly accumulation method, and precipitation elasticity of runoff method to analyze the changes in the relation of precipitation and runoff and the contribution of precipitation to runoff change in the Hekou-Longmen region (from 1957 to 2010), Huangfuchuan watershed (from 1954 to 2010), and Yanhe watershed (from 1952 to 2010) in the middle reaches of the Yellow River. The results showed that runoff appeared a significant decreasing trend (P = 0.01) while it was not significant in precipitation in all study areas. In particular, the reductions of average annual runoff in the Hekou-Longmen region, Huangfuchuan watershed, and Yanhe watershed were 72.7%, 87.5%, and 32.2%, respectively, during 2000-2010 compared to the 1950s. There existed two abrupt change points of the runoff in the Hekou-Longmen region and Huangfuchuan watershed, which were detected in 1979 and 1998. But in the Yanhe watershed only one abrupt change point was found in 1996. The precipitation elasticities of runoff were 1.11, 1.09, and 1.26, respectively, and the contributions of precipitation on runoff reduction were 26.4%, 17.9%, and 31.6%, respectively, in the Hekou-Longmen region, Huangfuchuan watershed, and Yanhe watershed.