Serious soil losses on the Loess Plateau are the main source of sediments in the Yellow River. Large-scale implementation of soil and water conservation measures since the 1950s is one of the key actions for decreasing soil and water losses in this region. Soil and water conservation measures can modify hydrological processes and soil loss processes on hillslopes or in channels by changing hydrological pathway, runoff velocity, and sediment transportation, and then change the spatial and temporal distribution of water and soil resources at corresponding scales. Different types of soil and water conservation measures played substantial roles in sediment trapping, hydrological adjustment, and regional food security maintenance on the Loess Plateau during the past decades. Soil and water conservation measures have a substantial contribution in reducing the sediment loads of the Yellow River, and are important for maintaining ecological security in the Yellow River Basin. This study aimed at (1) systematically summarizing the types and development of soil and water conservation measures on the Loess Plateau for the past seven decades; (2) revealing the effects of soil and water conservation measures on hydrological and soil processes and related critical ecosystem services and underlying mechanisms at multiple spatial scales; and (3) presenting the problems, challenges, and future prospects of soil and water conservation measures on the Loess Plateau. It is suggested that implementation of soil and water conservation measures on the Loess Plateau in the future needs to focus on their maintenance and improvement toward integrated benefits, strengthen their resilience to extreme climate events and natural hazard-induced disasters, and balance tradeoffs among social-economic-ecological benefits. Improvement in the effectiveness of soil and water conservation measures can help maintaining ecological security and enhancing regional ecosystem functions of the Loess Plateau.