Abstract: The influence and control factors of the regional geomorphic patterns, such as the plane shape and the flow directions of the mainstream and tributaries of the river system, in the middle reaches of the Yellow River, and the effects of the regional geomorphic patterns on soil and water loss, ecological and economic development, have long been one of the hot debates that have received much attention. In this study, we select the Huangfuchuan, Gushanchuan and Zhujiachuan–Xianchuan drainage in the northern reaches of the middle Yellow River as the research objects. Based on high–precision DEM extraction of the drainage system, statistics of flow direction, as well as systematic investigation and measurement of the structural styles and attitudes of the joints and/or faults in bedrock and loess, combined with the tectonic background of the study area since the Cenozoic, it is proposed that the series of vertical joints and faults formed by regional extension in the northern reaches of the middle Yellow River are key factors that influence or control the development and spreading characteristics of the drainage patterns.