Sediment in rivers is the dominant material source for ecosystems in lower reaches and estuaries, and it is undergoing large variations globally in recent decades. Though we have knowledge that human activities are greatly affecting land surface ecosystem processes and functions, the relationships between sediment transport regime and the intensifying human activities, are still poorly understood. This study was to investigate the changes of sediment transport regime due to the large-scale ecological restoration in the Middle Yellow River Basin (MYRB). In this study, we examined the change of the sediment rating curves using daily sediment load and streamflow data from 30 stations during time periods including pre- and post-ecological restoration in this region. We found the pair-relationship of the rating parameters (coefficient and exponent), denoted as coefficient-exponent pair-line, is a critical indicator that can detect the shift of sediment transport regime due to disturbed land surface conditions, though the changed hydrometeorological condition may just influence the absolute values of the rating parameters. Our analysis indicates there was a significant and interesting change of the sediment transport regime in the MYRB characterized by the consistent shift of the coefficient-exponent pair-line, together with an increasing exponent and a decreasing coefficient. This changed sediment transport regime can tell that sediment delivery would become lower for normal discharge conditions but potentially higher for extreme discharge conditions, and this phenomenon seems more distinct in relatively smaller watersheds, suggesting a higher risk of the potential high sediment delivery for extreme rainfall conditions especially for small watersheds. Our study would be informative and valuable to decision makers for sustainable watershed management in the MYRB when considering the changed sediment delivery.