Abstract: The East River basin is the major source of water supply for megacities in the Pearl River Delta and Hong Kong. Intensifying development of water resources and reservoir-induced hydrological alterations negatively affect ecological hydrological requirements. In this study, hydrological alterations and environmental flow variation are determined. Results indicate that: (1) multi-day maxima have reduced, while multi-day minima have increased, due to hydrological regulations of water reservoirs; (2) hydrological regimes of the East River have also been severely affected by hydropower generation, leading to a greater frequency of high and low pulses of lesser duration, and these effects are increasingly evident from the upper to lower East River basin; (3) owning to the water being released rapidly for hydropower generation or flood protection, the number of hydrologic reversals have increased after reservoir operations, also with increasing rise and fall rate; and (4) the alteration of three different types of environmental flow components have been shown in the study, which can be used to support the determination of environmental flow requirements in the East River basin.