The Sarez Dam, currently recognized as the world’s highest natural dam, holds immense economic significance, necessitating the reliable monitoring and early detection of potential deformations. This study utilizes the Beidou high-precision deformation monitoring system for the dam. Employing baseline network solutions, precise point positioning, and real-time kinematic positioning, the monitoring data from October 2021 to March 2023 were meticulously processed and comparatively analyzed. The results reveal varied degrees of displacement deformation at all sites, with horizontal deformation towards the lake center and vertical deformation showing subsidence. The three-dimensional vector average displacement is 29.1 mm, with an average monthly rate of 4.3 mm/month, and the maximum deformation is 41.4 mm. The cause of the horizontal deformation towards the lake center may be a slow collapse of the coastal soil and rock towards the lake center. Additionally, the monitoring detected a 7.2-magnitude earthquake on 23 February 2023, 52 km from the dam, causing an average displacement of 22.5 mm towards the south, which is 20 times the monthly deformation rate. In summary, deformation is present within the dam monitoring area, with a relatively stable deformation rate, warranting continued tracking and monitoring. Furthermore, earthquakes significantly impact dam deformation, necessitating heightened attention to the potential for seismic-induced dam damage in the future.