The upper reaches of the Yellow River is the area where poverty is easy and frequent in China. In the context of winning the war against poverty in 2020, it is of great guiding significance to explore the characteristics of poverty reduction turn and high-quality development path for the regional sustainable development. Based on existing research on basin development and governance and national strategies and from the perspective of development geography, an analytical framework of the “five-in-one” geographic capital system and its spatial integration for poverty reduction and development in river basins were constructed. On the basis of defining the scope of the upper reaches of the Yellow River, the issues of poverty alleviation and development in this area was elaborated. The results show that: the incidence of poverty in the upper reaches of the Yellow River continued to decline, the population in poverty had been greatly reduced, and poverty alleviation will be realized after 2020. The geographic capital index values showed a clear upward trend, the increase rate was higher than the Yellow River Basin (0.078) and the national average levels (0.067). However, geographic capital was still restricted by the low income level of urban and rural residents, lower urbanization level, weak research and development intensity of industrial enterprises, weak trade dependence, lower patent density, weak technological market level, and other constraints. Under the background of poverty alleviation and regional convergence, a conceptual model of poverty governance and high-quality development was proposed considering the localization, regionalization, and globalization of regional sustainable poverty reduction and development.