The upper and middle of the Yellow River Basin (UMYRB) are globally recognized as an ecologically fragile region due to severe soil erosion, arid climate, and frequent extreme weather events. Over the past two decades, large-scale ecological restoration measures have led to pronounced changes in ecosystem services (ES). However, there is a lack of systematic analysis addressing the spatiotemporal dynamics and driving mechanisms of multiple ecosystem services under the combined effects of ecological restoration projects and extreme climatic events. To fill this gap, this study employed the InVEST model, geographically weighted regression, and partial least squares structural equation modeling to comprehensively investigate the evolution of various ecosystem services in this basin and their key influencing factors. The results indicate that (1) in regions where vegetation recovery was particularly successful, water yield (WY) increased from 24 mm to 88 mm and soil conservation (SC) capacity was substantially enhanced; carbon storage (CS) rose by approximately 12 % in the humid southern area but remained stable in the arid northern region. (2) Precipitation, slope, vegetation cover, and land-use changes collectively shaped the spatial patterns of ecosystem services, with precipitation exhibiting the strongest explanatory power for WY, and slope together with vegetation recovery exerting notable impacts on SC. (3) In areas of vegetation recovery, multiple ecosystem services showed stronger synergy, whereas habitat quality (HQ) and CS exhibited significant trade-offs in regions experiencing agricultural expansion. (4) Extreme precipitation events markedly amplified the variability of WY, SC, and CS, accounting for 61.5 %, 57.8 %, and 27.4 % of their respective variances, while exerting relatively limited effects on HQ. These findings elucidate the mechanisms by which ecological restoration projects and extreme precipitation events jointly influence multiple ecosystem services, and provide scientific guidance for targeted ecological management and service optimization in UMYRB.