Desertification is a critical environmental problem in China's northwestern region. In this context, since the early 2000s, projects targeting ecological restoration have been implemented in the lower reaches of the Heihe River basin. Using multi-scale remote sensing data and field observations, this paper examines the outcomes of the ecological restoration projects. Specifically, this paper examines the vegetation change through remote sensing and local perceptions of the projects through semi-structured questionnaires. The results from remote sensing reveal that during the restoration projects, vegetation coverage in riparian areas of the lower reaches of the Heihe River basin increased. However, this increase cannot be simply equated with ecological recovery. Expansion of farmland and afforested areas have also contributed to the increase in vegetation coverage. Questionnaire results reveal that although locals perceived improvements in the ecological conditions of the lower reaches, most of them were more about future environmental changes. Additionally, results indicate that ecological restoration projects redistributed water resources in the local river reaches and, as a result, local residents living in riparian areas perceive greater benefit. Therefore, the implementation of the project may have actually negatively impacted the water accessibility of those living in the drier Gobi Desert areas.