Abstract: A systematic review of recent advances in observations, physical mechanisms, and numerical simulations pertaining to land-atmosphere interaction process and its climatic effects over the Tibetan Plateau is provided. On the observational front, the progressive development of a comprehensive multi-sphere interactive three-dimensional observation network across the plateau has furnished a robust data foundation for quantifying energy and water fluxes over its heterogeneous underlying surface. Evapotranspiration (ET) research has evolved from bulk-flux estimation to component-based partitioning, revealing that soil evaporation accounts for over 84% of total ET, while model refinements have significantly improved ET retrieval accuracy. Boundary layer observations show that the convective boundary layer over the Qinghai-Xizang Plateau can develop to heights of 3–4 km, far exceeding those over plains at the same latitudes, and its spatiotemporal evolution is jointly regulated by the monsoon, sensible heating, and westerly dynamics. In the realm of numerical modeling, the optimization of critical parameters—including gravel thermal properties, permafrost processes, and snow albedo—has effectively mitigated systematic model biases, yielding substantial enhancements in the simulation of latent heat flux and near-surface air temperature. In terms of climatic impacts, the plateau’s sensible heating drives the Asian monsoon via the "air-pump" mechanism, and through teleconnections and soil-moisture memory, it exerts a strong control on summer precipitation over East Asia. Quantitative attribution shows that land-surface forcing contributes slightly more to precipitation variability (0.52) than oceanic forcing (0.42). Looking ahead, future efforts should prioritize the establishment of a "digital twin" observation framework, coupled with the integration of artificial intelligence and data assimilation techniques, to sharpen predictive capabilities for climate change over the Qinghai-Xizang Plateau and its far-reaching global consequences.