The dam is multi-purpose and was constructed for flood and ice control along with irrigation, hydroelectric power generation and navigation.

The effects from sediment, which include flooding upstream, have placed the dam at the center of controversy and criticism-related arrests by the Chinese government.

In response to centuries of flooding on the Yellow River, engineers initially proposed the Sanmenxia Dam in early 1935.

The design was revised to a maximum level of 340 m (1,115 ft) ASL which required the relocation of 400,000 people and flooded much less area.

The report was submitted to the National People's Congress and swiftly approved that same year while preliminary construction began soon after.

In June 1960, the reservoir was at full pool and the dam crest reached its design elevation of 353 m (1,158 ft) ASL in April 1961.

At the meeting, it was decided to reconstruct the dam's outlet works for improved discharges and silt control.

The first stage included the installation of two tunnels on the dam's left bank at an elevation of 290 m (951 ft) ASL along with converting four penstocks into flushing pipes.

[6] In August 2010, Chinese journalist Xie Chaoping was detained for writing The Great Migration, a book that criticized the dam and the government's handling of it.