The purpose of this study was to evaluate the role of rainfall during wet periods and meteorological droughts in recent years to decrease the impact of river flow droughts in the Karkheh basin. To this end, the hydrology-land surface coupled model ALSIS-HBV was used. The application of this model to an undisturbed period (when the system is only affected by natural factors) and to a disturbed period (the system is affected by both human and natural factors) will allow the defined goal to be achieved. The threshold level method was used to monitor meteorology and hydrology drought. Findings show that the time delay between meteorological drought and river flow drought in different sub-basins is between 15 to 90 days. When meteorological drought is more severe and prolonged, the time required to improve river flow drought will be increased. In the undisturbed period, the river flow response is rapid and river flow droughts are improved with a delay of 1 to 3 months. The process of improving the river flow is slowed down during the disturbed period, and this trend has been slower in the last decade. Comparisons of P/Qobs ratios (precipitation to river flow observations) and P/Qsim (precipitation to simulated river flow) show, due to minor variations of P/Qsim, that the coupled model simulates the river flow response to precipitation anomalies. However, in actual conditions of the basin, due to human involvement in nature, this ratio has been increased in disturbed periods. The results of drought recovery for river flow for the dry period of 2008-2013 with increasing rainfall scenarios show that in the sub-basins of Gamasyab, Qare Sou, and the entire Karkheh basin, in order to recover drought of the river flow in the high flow, rainfall should be higher than the long average and requires extreme rainfall. In the years under study, increasing the mean temperature and evapotranspiration from surface water could be a detrimental factor in high flood recovery.