Changes in precipitation are critical indicators of climate change. In this study, the daily precipitation records from 10 meteorological stations in the Heihe River Basin, Northwest China from 1961–2016, precipitation indices, climate indices, and the normalized differential vegetation index (NDVI) were investigated using the Pearson, Kendall, and Spearman correlation coefficients; Theil-Sen Median; Mann–Kendall test; and wavelet coherence. The results indicated that the occurrences (fractional contributions) of 1–2-day wet periods were 81.3% (93.9%) and 55.3% (82.1%) in the upper (UHRB) and middle (MHRB) reaches of the Heihe River Basin, respectively. The spatial distribution of the occurrences (fractional contributions) was almost consistent with non-significant increases/decreases at stations. The ATP, ATD, API, and AMRD increased, while precipitation regimes suggest that dry seasons are getting wetter, and wet seasons are getting drier, although these changes were not significant. Wavelet coherence analyses showed that climate indices influenced precipitation, mainly its concentration, on a 4- to 78.6-month timescale. The Pearson, Kendall, and Spearman correlation coefficients showed weak lagged linkages between precipitation and the North Arctic Oscillation (NAO), Pacific Decadal Oscillation (PDO), and Atlantic Multidecadal Oscillation (AMO). The NDVI of grasslands, meadows and coniferous forests was significantly and positively correlated with precipitation, while the NDVI of alpine vegetation, swamps and shrubs was negatively and significantly correlated with precipitation in the UHRB. The NDVI of grasslands was significantly and positively correlated, but the NDVI of shrubs, coniferous forests and cultivated vegetation was negatively and significantly correlated with precipitation in the MHRB. The correlation between cultivated vegetation and natural precipitation in the MHRB may have been weakened by human activities.