Hydrological drought for marshy rivers is poorly characterized and understood. Our inability to quantify hydrological drought in marshy river environments stems from the lack of understanding how wetland loss in a river basin could potentially change watershed structure, attenuation, storage, and flow characteristics. In this study, hydrological drought in a marshy river in far Northeast China at a higher latitude was assessed with a streamflow drought index (SDI). A deterministic, lumped, and conceptual Rainfall–Runoff model, the NAM (Nedbor Afstromnings Model), was used to quantify the individual contributions of climate change, land use/land cover (LULC) change, and river engineering to hydrological drought. We found that in the last five decades, the frequency of hydrological droughts has been 55% without considering LULC change and reservoir construction in this wetland-abundant area. The frequency of hydrological drought increased by 8% due to land use change and by 19% when considering both the impacts of LULC change and a reservoir construction (the Longtouqiao Reservoir). In addition to the more frequent occurrence of hydrological droughts, human activities have also increased drought intensity. These findings suggest that LULC and precipitation changes play a key role in hydrological drought, and that the effect can be significantly modified by a river dam construction.