Food is essential for human sustenance, and the ecological footprint of regional food consumption reflects the land resources necessary to support the population. Analyzing the residents' food consumption, structure, and associated resource and environmental costs holds significance for enhancing food supply, reinforcing regional ecological preservation, and revising food security strategies, particularly in ecologically fragile areas. This study utilized primary data from field research conducted in 2018 on household food consumption in the rural areas along the Yarlung Zangbo River and its two tributaries on the Qinghai-Tibetan Plateau. It examines the volume and composition of residents' household food consumption and computes their ecological footprints. The primary findings are: (i) The residents in the rural areas of the Yarlung Zangbo River and its two tributaries have a per capita annual food consumption of 482.44 kg, with the regional total reaching 369,000 tonnes. Plant-based food consumption constitutes 74.4%, nearly 2.91 times greater than that of animal-based food (25.6%); in the consumption composition, vegetables comprise the largest share (29.4%), followed by barley (20.7%) and milk (15.3%). Beef and mutton predominantly contribute to meat consumption, accounting for 88.4% of the total meat consumption. (ii) The cumulative ecological footprint from food consumption reaches 414,100 hm², which is 2.48 times the arable land in three city areas (Lhasa, Shigatse, Shannan) within the Yarlung Zangbo River and its two tributaries region. In which, 55.6% (230,200 hm²) constitutes the direct ecological footprint, predominantly from cropland (61.2%, 140,900 hm²), complemented by grassland (88,100 hm²) and woodland (1200 hm²). Meat consumption accounts for the most substantial ecological footprint at 51.1%. 30.8% of the ecological footprint from food consumption originates from external sources, with Gansu Province (9.2%), Qinghai Province (8.0%), and Xinjiang Uygur Autonomous Region (5.2%) being the primary contributors. The study results hold practical importance in reconfiguring local agricultural practices, refining the food supply-demand dynamic in Tibet, safeguarding the ecological environment of the Qinghai-Tibetan Plateau, and shaping pertinent policies.