The effects of land-use change on river flows have usually been explained by changes within a river basin. However, land-atmosphere feedback such as moisture recycling can link local land-use change to modifications of remote precipitation, with further knock-on effects on distant river flows. Here, we look at river flow changes caused by both land-use change and water use within the basin, as well as modifications of imported and exported atmospheric moisture. We show that in some of the world's largest basins, precipitation was influenced more strongly by land-use change occurring outside than inside the basin. Moreover, river flows in several non-transboundary basins were considerably regulated by land-use changes in foreign countries. We conclude that regional patterns of land-use change and moisture recycling are important to consider in explaining runoff change, integrating land and water management, and informing water governance.