Rivers worldwide are under significant stress due to various human interventions, including the indiscriminate extraction of water through dams and barrages, the mining of gravel and sand from riverbeds, changes in land use and land cover within the catchment areas, the construction of cross-bridges, the establishment of brick kilns along riverbanks, the regulation of river floods through embankments, and encroachments on river spaces. These stresses are particularly pronounced in the rain-fed Silabati River. This river is characterized by its elongated shape. It exemplifies a typical upstream–downstream division of a plateau-fringe and plain river basin. The upstream plateau-fringe section is dominated by erosional features, while the downstream plain section is more depositional in nature. In this drought-prone region, distinct landforms have developed across the basin due to seasonal variations in river flow. Furthermore, human interventions—such as lift irrigation in the upstream areas and canal irrigation and flood control in the downstream areas—have significantly altered sediment supply and water discharge patterns. This study finds that human activities, including the construction of earthen-boulder dams, pick-up barrages, weirs, embankments, as well as the mining of gravel and sand and the construction of both permanent and temporary cross-bridges, have caused notable changes in the geomorphologic and hydrological characteristics of the river basin. The study aims to analyse the human-induced impacts on the Silabati River and propose remedial measures to restore the river's sustainability. It concludes with a set of practical suggestions aimed at promoting the long-term health and sustainability of the river.