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Geochemical data of altered wall rocks are important for the metallogenic prognosis of hydrothermal gold deposits. Indicator elements of altered wall rocks such as K, Al, As, Sb, and Hg have been successfully used to assess gold anomalies in lithogeochemical survey. However, such researches have rarely been done in stream sediment survey for the exploration of gold from various landscapes. On the basis of the geochemical analysis of altered wall rocks of gold deposits in the cold desert areas of Gansu Province in Northwest China, it is found that the combination of Al, K, and Sn could serve as an important indicator of hydrothermal gold deposits and can be used to evaluate the metallogenic prospective of gold anomalies in stream sediments. More studies performed in the cold grassland areas and the moderate-low relief mountainous areas showed that, both weak and strong geochemical anomalies can be extracted, if strictly abiding by the ways of calculation and addition of the binary values of the indicator elements with equal weight, and this provides the sound delineation of metallogenic perspective areas.