The Tibetan Plateau covers the largest distribution of wetlands in China, and its unique alpine wetlands are indispensable for regional ecological security. This paper summarized the spatiotemporal variation characteristics of wetlands on the Tibetan Plateau, focusing on the impact mechanism of climate change and human activities on different wetland types. The main findings are presented as follows: (1) the climate factors dominated the wetland changes vary with wetland types and regions. Specifically, lacustrine wetlands expand in the north but shrink in the south, which corresponds with the spatial pattern of precipitation, indicating that the lacustrine wetlands variation is mainly driven by precipitation. Palustrine wetlands are mainly affected by temperature. The increase in temperature leads to water evaporation, vegetation community succession, palustrine wetlands conversion to grassland, and degradation of main distribution areas such as the Yangtze, Yellow River source regions and the Zoige Plateau. Furthermore, riverine wetlands are mainly affected by temperature. The increased temperature accelerates the glacier melting of river sources and increases the evapotranspiration of rivers, jointly causing the decrease of riverine wetlands in the north while increasing in the south. (2) Overgrazing, peat mining and water conservancy construction are the main human activities affecting wetland changes. Under the joint influence of overgrazing, peat mining and ditch construction, the palustrine wetlands degrade sharply on the Zoige Plateau. Meanwhile, the constructed wetlands in the Qaidam Basin are rapidly expanding due to salt mining. (3) Less comparability of wetland data, lack of continuous monitoring data at large regional scale and field fixed-points lead to insufficient in-depth research on the impact mechanism of climate change and human activities on alpine wetlands. In the future, it is urgent to strengthen the regular monitoring and risk assessment of alpine wetlands, improve the research on the interaction mechanism between alpine wetland ecosystems, the environmental change and human activities, and pay attention to the ecological process of alpine wetlands, to provide important scientific support for building nationally ecological security barrier.