The alpine mountain watersheds of the Qinghai-Tibetan plateau stand as pivotal water sources in Asia, serving as vital reservoirs for the region’s ecohydrological balance. Their significance in sustaining the Qinghai-Tibetan plateau and its surrounding areas is undeniable. A comprehensive grasp of water replenishment, the impacts of climate change, and responses to alterations in runoff dynamics on the Qinghai-Tibetan Plateau is paramount for the effective management and utilization of water resources amidst the backdrop of global warming. This research highlights that, amidst the backdrop of climate change, there is a noticeable alteration in the runoff recharge mechanisms within certain watersheds. Concurrently, it observes a general trend towards a heightened contribution of rainfall to runoff volumes across the majority of these basins. In the major alpine basins of the Tibetan Plateau, rainfall emerges as the predominant runoff source. The contribution of groundwater to the hydrological cycle is non-negligible, and the influence of snow and ice meltwater is intricately tied to the extent of glacial and snow-covered regions. The study’s findings draw attention to a general upward trend in runoff depths across the majority of the watersheds, contrasted with a downward trend observed in certain watersheds within the Riverside Corridor. Furthermore, the study delineates the disparate effects of climate change and anthropogenic activities/land use alterations on runoff patterns. It reveals a trend in some watersheds where the impact pattern is undergoing a shift, with the majority exhibiting a progressive enlargement of the climate change impact sphere.