A regional tree-ring width chronology of Schrenk spruce (Picea schrenkiana) was used to determine the annual (previous July to current June) streamflow of the Kuqa River in Xinjiang, China, for the period of 1414–2015. A linear transformation of the tree-ring data accounted for 63.9% of the total variance when regressed against instrumental streamflow during 1957–2006. The model was validated by comparing the regression estimates against independent data. High streamflow periods with a streamflow above the 602-year mean occurred from 1430–1442, 1466–1492, 1557–1586, 1603–1615, 1687–1717, 1748–1767, 1795–1819, 1834–1856, 1888–1910 and 1989–2015. Low streamflow periods (streamflow below the mean) occurred from 1419–1429, 1443–1465, 1493–1556, 1587–1602, 1616–1686, 1720–1747, 1768–1794, 1820–1833, 1857–1887 and 1911–1988. The reconstruction compares well with the tree-ring-based streamflow series of the Tizinafu River from the Kunlun Mountains; both show well-known severe drought events. The streamflow reconstruction also shows highly synchronous upward trends since the 1980s, suggesting that streamflow is related to Central Asian warming and humidification. Thus, the influences of the extremes and the persistence of low streamflows on local society may be considerable. Climatic changes in the watershed may be responsible for the change in the hydrologic regime of the Tarim Basin observed during the late twentieth century.