The Qinghai–Tibet Plateau is a unique global natural geographical unit with a high altitude and fragile ecology, where land cover change has been affecting its regional ecological security and sustainable development. The plateau covers nine countries with different variations in climate change and human activities, which cause significant spatial variations in its land cover change. This paper uses land cover data to reveal the spatiotemporal characteristics and multi-country differences in land cover change on the Qinghai–Tibet Plateau from 1992 to 2020 by applying spatiotemporal characteristic analysis and mapping methods. The results show that grassland (65.70%), bare land (15.56%), and woodland (10.25%) are the main types of land cover on the plateau, accounting for 91.51% of the total area. The interconversion of bare land and grassland was dominant in 1992–2020, with an area share of 67.83%. The turning point year of grassland change occurred in 2015. The grassland area increased by 6312 km2 in 1992–2015, while it decreased by 14,646 km2 in the plateau in 2015–2020. The areas of woodland, cropland, and water increased by 2.77%, 5.85%, and 7.57%, respectively, and the area of built-up land increased from 299.17 km2 to 1206.29 km2. Overall, a warming and wetting trend of the climate in the Qinghai–Tibet Plateau has driven the expansion of natural vegetation and water in the central plateau within China, with its natural vegetation area increasing by 0.11%. However, the development of regional warming and drying caused local grassland degradation, where Kyrgyzstan and India within the Qinghai–Tibet Plateau experienced the most prominent vegetation degradation. Human activities are relatively frequent in the Qinghai–Tibet Plateau within China and India, causing higher growth rates of built-up land and cropland than in other countries. The establishment of reserves and effective forest management policies have led to significant increases in woodland areas in China and Nepal within the plateau, while weak forest management and limited investment in forest conservation have led to high rates of deforestation in India and Myanmar. Accelerated temperature rises and regional differences in precipitation are the main drivers of large-scale land cover change on the plateau and differences in human activities and land use policies are responsible for the dramatic and diverse localized land cover change.