Ecosystem services (ESs) are the cornerstone of human well-being. On the Tibetan Plateau and in its subregions, understanding the effects of the spatiotemporal continuity in the trade-offs/synergies of ESs, and identifying their drivers, is crucial for ecosystem conservation and sustainable development. In this study, we investigated the spatiotemporal variation of four ESs (WY, water yield; SR, soil retention; HQ, habitat quality; CS, carbon sequestration) on the Tibetan Plateau, in 2000-2020. We introduced a new indicator (RESI, Index of the relationships between ESs) to measure the trade-offs/synergies among ESs and their magnitudes, and used GeoDetector to analyze the drivers of ESs and their relationships. The following results were obtained: (1) The four ESs exhibited similar geographical characteristics, being higher in the southeast and lower in the northwest. The spatiotemporal variation of WY and SR was similar to the precipitation trend. WY, SR and CS increased significantly (p < 0.05) in the region by 10.60%, 14.59% and 29.29%, respectively, while HQ remained stable across 79.41% of the area. (2) Most ES relationships on the Tibetan Plateau were found to be synergistic, except for WY_HQ, where trade-offs were observed, with trade-offs and synergistic areas accounting for 49% and 48%, respectively. (3) The climate was found to be a key driver of ESs and their relationships on the Tibetan Plateau. However, apart from climate, human activity was found to be dominant along the middle reaches of the Brahmaputra, while vegetation and topography dominated in Naqu on the Qiangtang Plateau and Southeast Tibet, respectively. This study uncovers disparities in the impacts of natural and human activity factors on ES relationships, providing valuable insights for decision-makers to maximize the benefits of ESs.