The Qinghai-Xizang Plateau, or Tibetan Plateau, is a sensitive region for climate change, where the manifestation of global warming is particularly noticeable. The wide climate variability in this region significantly affects the local land ecosystem and could consequently lead to notable vegetation changes. In this paper, the interannual variations of the plateau vegetation are investigated using a 21-year normalized difference vegetation index (NDVI) dataset to quantify the consequences of climate warming for the regional ecosystem and its interactions. The results show that vegetation coverage is best in the eastern and southern plateau regions and deteriorates toward the west and north. On the whole, vegetation activity demonstrates a gradual enhancement in an oscillatory manner during 1982-2002. The temporal variation also exhibits striking regional differences: an increasing trend is most apparent in the west, south, north and southeast, whereas a decreasing trend is present along the southern plateau boundary and in the central-east region. Covariance analysis between the NDVI and surface temperature/precipitation suggests that vegetation change is closely related to climate change. However, the controlling physical processes vary geographically. In the west and east, vegetation variability is found to be driven predominantly by temperature, with the impact of precipitation being of secondary importance. In the central plateau, however, temperature and precipitation factors are equally important in modulating the interannual vegetation variability.