Slope ecological restoration and climate change are important factors affecting the hydrological processes of the Huangshui River Basin in Qinghai province, China. How to quantitatively identify the impact of slope ecological restoration on runoff and whether slope ecological restoration can mitigate the impact of future climate change on runoff are both very important. In this paper, the Huangshui River above the center of Minhe county was taken as the research area, and the Pinus tabulaeformis and shrubs were taken as the main forest land types of slope ecological restoration. First, based on the law of forest land variation, the construction scales of slope ecological restoration in different periods were identified. The influence of slope ecological restoration on runoff was then quantitatively evaluated by using a distributed hydrological model. Second, the future climate scenarios of five general circulation models (GCMs) under three representative concentration pathways (RCPs) (i.e., RCP2.6, RCP4.5, and RCP8.5) from 2021 to 2050 were selected and modified by model integration. Combined with the slope ecological restoration scenarios, the influence of slope ecological restoration on runoff under future climate scenarios was explored. The results showed that the effect of slope ecological restoration was significant. Compared with 1980, the area of slope ecological restoration increased by 24% in 2017. Under the present climate conditions (1960–2017), different periods of slope ecological restoration have an effect on the process of runoff in the wet season (June, July, August, and September) and dry season (January, February, March, and December), which eliminates the maximum, replenishes the minimum, and reduces the variability of runoff processes in the watershed. Under the future climate scenario (2021–50), slope ecological restoration will reduce runoff. On the other hand, climate change will increase runoff, and the combination of the two effects will have a certain offsetting effect. On the whole, comparing the influence of slope ecological restoration on the runoff process with that of climate change in different seasons, due to the main influence of slope ecological restoration, the runoff decreased by about 55% in the temperate season (April, May, October, and November), and increased by about 50% in the dry season or wet season due to the main influence of future climate scenarios.