The Three-River Headwaters Region (TRHR) is crucial to the sustainable development of China and Southeast Asia. The sustainability of grassland ecosystems in the region has been seriously challenged in recent years. This paper reviewed the changes in the grasslands of the TRHR and their responses to climate change and human activities. The review showed that accurate monitoring of grassland ecological information is the basis for effective management. Although alpine grassland coverage and the above-ground biomass of the alpine grassland have generally increased in the region over the past 30 years, the degradation has not been fundamentally curbed. Grassland degradation substantially reduced topsoil nutrients and affected their distribution, deteriorated soil moisture conditions, and aggravated soil erosion. Grassland degradation led to loss of productivity and species diversity, and this is already harming the well-being of pastoralists. The “warm and wet” trend of the climate promoted the restoration of alpine grasslands, but widespread overgrazing is considered as one of the main reasons for grassland degradation, and related differences still exist. Since 2000, the grassland restoration policy has achieved fruitful results, but the formulation of the policy still needs to integrate market logic effectively and strengthen the understanding of the relationship between ecological protection and cultural protection. In addition, appropriate human intervention mechanisms are urgently needed due to the uncertainty of future climate change. For mildly and moderately degraded grassland, traditional methods are applicable. However, the severely degraded “black soil beach” needs to be restored by artificial seeding, and the stability of the plant–soil system needs to be emphasized to establish a relatively stable community to prevent secondary degradation.

The central region of the Eurasian continent is widely affected by arid conditions, but the valleys in front of the mountains nurture ecosystems consisting of forests, shrubs, and grasslands. Preserving the ecological balance in these arid valley areas is an essential aspect of water resource planning and management. This study utilizes calculations of vegetation’s ecological water consumption and water requirements to quantitatively simulate groundwater levels. These simulated levels are then compared with the threshold depth suitable for vegetation, ultimately leading to the development of an ecological security assessment method for valley areas. The results show the following: (1) During 30 years, the water demand of river valley vegetation increased slowly, and the overall stability is about 4.82 × 10⁸ m³. Among them, the ecological water demand of grassland is the largest. The water demand from June to August is about 68% of the whole year. (2) The results indicate that over a period of 30 years, the groundwater levels in the valley area have shown a gradual decline. The rate of decline in groundwater levels is approximately twice as fast in areas farther away from the river compared to areas closer to the river. The decline in groundwater levels typically begins in May each year. During the period of valley flooding in June, there is a temporary rise in water levels, followed by a continued decline afterwards. (3) The study area has a significant proportion of groundwater suitable areas, accounting for approximately 65% on average annually. Over the course of 30 years, the area experiencing groundwater deficiency has increased from 31% to 37%. (4) Over the past 30 years, the ratio of annual vegetation water consumption to water demand in the river valley has been slowly decreasing, and the vegetation growth status has changed from good growth to normal growth. (5) In the past 30 years, the area of ecological quality areas has decreased significantly, and most of them have been transformed into general areas. The area of ecologically fragile areas is increasing, and the area of fencing protected areas is slowly declining.