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Between 1851 and 1855, the Yellow River returned to the north amid the floods that provoked the Nien and Taiping Rebellions. The 1887 flood has been estimated to have killed between 900,000 and 2 million people, and is the second-worst natural disaster in history (excluding famines and epidemics). The Yellow River more or less adopted its present course during the 1897 flood.

The 1931 flood killed an estimated 1,000,000 to 4,000,000, and is the worst natural disaster recorded (excluding famines and epidemics).

On 9 June 1938, during the Second Sino-Japanese War, Nationalist troops under Chiang Kai-shek broke the levees holding back the river near the village of Huayuankou in Henan, causing what has been called by Canadian historian, Diana Lary, a "war-induced natural disaster". The goal of the operation was to stop the advancing Japanese troops by following a strategy of "using water as a substitute for soldiers". The 1938 flood of an area covering 54,000 km (20,800 sq mi) took some 500,000 to 900,000 Chinese lives, along with an unknown number of Japanese soldiers. The flood prevented the Japanese Army from taking Zhengzhou, on the southern bank of the Yellow River, but did not stop them from reaching their goal of capturing Wuhan, which was the temporary seat of the Chinese government and straddles the Yangtze River.

In 1954, the People's Republic of China announced its General Plan to Fundamentally Control Yellow River Flood Disasters and Develop Yellow River Waterworks. It sought to address both flooding risks and to convert rainfall-fed fields of the North China Plain to irrigated agriculture. Construction began in earnest in 1957.

From the 1970s to the 1990s, the dry-up trends accelerated, with the Yellow River failing to reach its mouth for an average of approximately 180 days per year in the 1990s. In 1997, the Yellow River did not reach the sea for 226 consecutive days.