Soil erosion has become a significant environmental problem that threatens ecosystems globally. The risks posed by soil erosion, the trends in the spatial distribution in soil erosion, and the status, intensity, and conservation priority level in the middle reaches of the Yellow River Basin were identified from 1978 to 2010. This study employed a multi-criteria evaluation method integrated with GIS and multi-source remote sensing data including land use, slope gradient and vegetation fractional coverage (VFC). The erosion status in the study region improved from 1978 to 2010; areas of extremely severe, more severe, and severe soil erosion decreased from 0.05%, 0.94%, and 11.25% in 1978 to 0.04%, 0.81%, and 10.28% in 1998, respectively, and to 0.03%, 0.59%, and 6.87% in 2010, respectively. Compared to the period from 1978 to 1998, the area classed as improvement grade erosion increased by about 47,210.18 km2 from 1998 to 2010, while the area classed as deterioration grade erosion decreased by about 17,738.29 km2. Almost all severe erosion regions fall in the 1st and 2nd conservation priority levels, which areas accounted for 3.86% and 1.11% of the study area in the two periods, respectively. This study identified regions where soil erosion control is required and the results provide a reference for policymakers to implement soil conservation measures in the future.