Objectives Numerous nature reserves have been instituted on the Qinghai-Tibet Plateau (QTP). The rationality of their spatial distribution serves as a crucial basis for assessing whether species face conservation gaps.

Methods Employing the existing statistical data concerning diverse reserve categories, we statistically analyzed their distribution patterns and characteristics, and conducted a spatial analysis with the distribution of human activity intensity, identifying issues in reserve construction and to propose future planning recommendations.

Results (1) QTP has established 54 national-level and 61 provincial-level nature reserves, encompassing an aggregate area of approximately 8.35×10⁵ km², constituting 32.32% of the plateau’s total area. These reserves currently provided refuge for the majority of endemic and rare endangered flora and fauna species on the plateau, thereby ensuring the conservation of this precious wildlife and significantly enhancing conservation outcomes. (2) Existing reserves exhibited uneven spatial distribution: large reserves were concentrated in high-altitude, species-poor uninhabited areas, while conflicts between humans and nature reserves were increasingly prominent in the biodiversity-rich, low-altitude valleys of the southeastern plateau with intense human activities. With the impacts of climate change and human activities, wildlife habitats will face significant disruption.

Conclusions This paper specifically proposed three key areas for future planning and development: the coniferous rainforest zone in the southern Tibetan valleys of the eastern Himalayas, the alpine deep-valley coniferous forest zone in the southeastern plateau, and the high-altitude shrub-meadow zone in the mountainous regions of the northwestern Sichuan. In the future, efforts should be concentrated on the coordination of the functions of reserves, both internally and among themselves. Such efforts should address conflicts between conservation, development, and the local economic growth. Furthermore, a long-term monitoring of the impact of climate change and human activities to nature reserves is highly needed. Integrated assessment of the efficiency of nature reserves should be caried out timely and make adjustments to planning and construction accordingly.