Manifold microchannel heat sinks (MMCHS) have been widely used in the thermal management of high heat flux electronic devices. To improve the temperature uniformity of MMCHS and reduce the hot spot temperature, a tapered-type manifold/variable cross-section microchannel heat sink (TMVC-MCHS) is proposed in this study. Key parameters affecting the heat transfer performance of TMVC-MCHS were first investigated numerically. The results indicate that the width inclination ratio (αw,in) of the inlet manifold has a greater influence on the coolant flow distribution than the height inclination ratio (αh,in), with a ratio of more than 2.5. In addition, the microchannel inclination (β) and width ratio (ε) affect significantly the fluid flow and heat transfer. To further improve the cooling effect of the heat sink, this study adopted XGBoost and multi-objective genetic algorithm (NSGA-II) to optimize the structure. The maximum temperature of the substrate (Tmax) and the total pressure drop (ΔP) are the optimization objectives. Besides, the compromise solution (αw,in = 0.40, β = 0.63 and ε = 0.52) was determined by TOPSIS combined with the entropy weight method which was validated by the CFD method with an error margin of only 3 %. Finally, Compared to MMCHS, the temperature field distribution uniformity of TMVC-MCHS is significantly improved. The maximum bottom surface temperature is drastically reduced from 337.79 K to 320.01 K, and the temperature difference is reduced from 17.5 K to 3.5 K, at the cost of only a 3.5 kPa pressure rise. For inlet flow rates ranging from 1 m/s to 2.5 m/s, the TMVC-MCHS exhibits a hydrothermal performance factor (PEC) improvement of over 35 %, indicating superior comprehensive performance.