The quantitative evaluation and prediction of ecosystem service value (ESV) in the Lhasa River Basin can provide a basis for ecological environment assessment and land-use optimization and adjustment in the future. Previous studies on the ESV in the Lhasa River Basin have focused mainly on static assessment and evolution analysis based on historical data, and have not considered future development trends. Moreover, most of the current driving factors selected in land use and ESV prediction studies are homogeneous, and do not reflect the geographical and cultural characteristics of the study area well. With the Lhasa River Basin as the research focus, 20 driving factors were selected according to the characteristics of the plateau alpine area, and the land-use changes under three developmental orientations, namely, natural evolution, ecological protection, and agricultural development, were predicted for the year 2030 with the FLUS-Markov model. Based on these predictions, the values of ecosystem services were calculated, and their spatiotemporal dynamic characteristics were analyzed. The results show that the model has high accuracy in simulating land-use change in the Lhasa River Basin, with a kappa coefficient of 0.989 and an overall accuracy of 99.33%, indicating a high applicability. The types of land use in the Lhasa River basin are dominated by the existence of grassland, unused land, and forest, with a combined proportion of 94.3%. The change trends of each land-use type in the basin under the three scenarios differ significantly, with grassland, cropland, and building land showing the most significant changes. The area of cropland increased only in the agricultural development scenario; the areas of forest and grassland increased only in the ecological protection scenario; and the expansion of building land was most effectively controlled in the ecological protection scenario. The ESV increased in all three scenarios, and the spatial distribution of the ESV per unit area in the middle and lower reaches was greater than that in the upper reaches. The ESV was the greatest in the ecological protection scenario, with grasslands, forests, and water bodies contributing more to the ESV of the basin. This study provides decision-making references for the effective utilization of land resources, ecological environmental protection planning, and urban construction in the Lhasa River Basin in the future.