Studying the spatiotemporal evolution and driving forces behind construction land amidst the intricate ecological and geological setting on the eastern edge of the Qinghai–Tibet Plateau offers invaluable insights for local sustainable development in a landscape transition zone and ecologically fragile area. Using construction land data from four phases, spanning 1990 to 2020, in Mianning County, this study employs methodologies like the Landscape Expansion Index (LEI) and land use transfer matrix to delineate the spatiotemporal evolution characteristics of construction land. A comprehensive set of 12 influencing factors across five categories—geomorphology, geological activity, climate, river and vegetation environment, and social economy—were examined. The Geographically Weighted Regression (GWR) model was then employed to decipher the spatial distribution pattern of construction land in 1990 and 2020, shedding light on the driving mechanisms behind its changes over the three decades. The research reveals distinct patterns of construction land distribution and evolution in Mianning County, shaped by the ecological and geological landscape. Notably, the Anning River wide valley exhibits a concentrated and contiguous development mode, while the Yalong River deep valley showcases a decentralized development pattern, and the Dadu River basin manifests an aggregation development mode centered around high mountain lakes. Over the study period, all three river basins witnessed varying degrees of construction land expansion, transitioning from quantitative expansion to qualitative enhancement. Edge expansion predominantly characterizes the expansion mode, complemented by leapfrog and infilling modes, accompanied by conversions from cropland and forest land to construction land. An analysis of the spatial pattern and drivers of construction land change highlights human-induced factors dominating the Anning River Basin, contrasting with natural factors prevailing in the Yalong River Basin and the Dadu River Basin. Future efforts should prioritize climate change considerations and environmental capacity, aiming for an ecologically resilient spatial pattern of construction land.