Cotton is an important economic crop and strategic resource. Monitoring its growth and analysing its response to meteorological factors are crucial for field management and yield estimation. This study selects the primary cotton-producing regions in northern Xinjiang as the study area. Firstly, using the Google Earth Engine cloud platform, the Cotton Mapping Index (CMI) was utilised to extract cotton planting areas from 2019 to 2023. Secondly, Sentinel-2A data were used to calculate the NDVI of cotton during the growing season and analyse its variation characteristics. Finally, correlation, lag, and partial correlation analyses were conducted between cotton NDVI and meteorological factors, including effective accumulated temperature, wind speed, precipitation, and solar shortwave radiation, to explore the response relationship. The results indicate the following: (1) The optimal classification threshold of CMI in the study area was determined to be 0.74, which was applied to extract cotton planting areas over the years. The overall classification accuracy achieved was 84.85%. The R2 value for the cotton area extracted by CMI compared to the cotton planting area in the statistical yearbook data is 0.98, with an average relative error of 16.84%. CMI’s classification use effectively distinguishes cotton from other major crops, such as wheat and corn, in the study area. Compared with different classification methods, CMI is more convenient and efficient for extracting cotton planting areas, contributing significantly to yield estimation and management. (2) We found that from 2019 to 2023, some fields were planted with cotton yearly. In order to prevent land degradation, a crop rotation system should be implemented, in which cotton rotates with other crops to reduce the rate of soil nutrient loss and achieve sustainable agricultural development. (3) NDVI can effectively monitor the spatiotemporal changes and regional variations in cotton growth. Sentinel-2 multi-spectral imagery possesses high spatial and temporal resolution, enabling effective monitoring of cotton growth, provision of cotton growth data for field managers, and application in cotton production management. Additionally, cotton yield estimation can be achieved by comparing the overall growth of cotton across different years. (4) Cotton NDVI exhibits a strong correlation with effective accumulated temperature and solar radiation, with the majority passing the significance test, suggesting a significant promotion effect on cotton growth by accumulated temperature and solar radiation. In cotton cultivation management, attention should be directed toward monitoring changes in accumulated temperature and solar radiation. Moreover, NDVI changes in response to solar radiation exhibit a certain lag. The correlation between NDVI and precipitation is low, likely attributed to local cotton cultivation primarily relying on drip irrigation. Cotton NDVI is negatively correlated with wind speed. Cotton planting should consider weather changes and take corresponding preventive management measures. The research results have significant reference value for monitoring cotton growth, disaster prevention, and sustainable agricultural development.