Due to irrational human activities and extreme climate, the Qinghai-Xizang Plateau, China, faces a serious threat of desertification. Desertification has a detrimental effect on the ecological environment and socioeconomic development. In this study, the desertification sensitivity index(DSI) model was established by integrating the spatial distance model and environmentally sensitive area index evaluation method, and then the model was used to quantitatively analyze the spatial and temporal characteristics of desertification sensitivity of the Qinghai-Xizang Plateau from 1990 to 2020. The results revealed that:(1) a general increasing tendency from southeast to northwest was identified in the spatial distribution of desertification sensitivity. The low-sensitivity areas were mostly concentrated in the Hengduan and Nyaingqêntanglha mountains and surrounding forest and meadow areas. The high-sensitivity areas were located mainly in the Kunlun and Altun mountains and surrounding decertified areas. The center of gravity of all types of desertification-sensitive areas moved to the northwest, and the desertification sensitivity showed a decreasing trend as a whole;(2) the area of highly sensitive desertification areas decreased by 8.37%, with extreme sensitivity being the largest change among the sensitivity types. The desertification sensitivity transfer was characterized by a greater shift to lower sensitivity levels(24.56%) than to higher levels(2.03%), which demonstrated a declining trend;(3) since 1990, the change in desertification sensitivity has been dominated by the stabilizing type Ⅰ(29.30%), with the area of continuously increasing desertification sensitivity accounting for only 1.10%, indicating that the management of desertification has achieved positive results in recent years; and(4) natural factors have had a more significant impact on desertification sensitivity on the Xizang Plateau, whereas socioeconomic factors affected only localized areas. The main factors influencing desertification sensitivity were vegetation drought tolerance and aridity index. Studying spatiotemporal variations in desertification sensitivity and its influencing factors can provide a scientific foundation for developing strategies to control desertification on the Qinghai-Xizang Plateau. Dividing different desertification-sensitive areas on the basis of these patterns of change can facilitate the formulation of more targeted management and protection measures, contributing to ecological construction and sustainable economic development in the area.