Ecological sensitivity measures an ecosystem’s reaction and restoration difficulty to exogenous disturbances. Regional ecological and environmental challenges can be identified using ecological sensitivity evaluation. The regional characteristics and environmental challenges of plateau lakes were quantified to create four assessment indexes: landform, natural conditions, human activities, and ecological security. Eleven ecologically sensitive characteristics were chosen. We evaluated the landscape ecological sensitivity of the Erhai Lake Basin, China, using ArcGIS and the analytical hierarchy process (AHP). The results showed that the Erhai Lake Basin was mostly forest from 1990 to 2020 and that the dynamic land-use attitude increased and then reduced. The cultivated land became mostly woods and grassland. The largest building area was tied to reverting farms to woods and urban construction. The highest weight was from single-factor ecologically sensitive vegetation covering, followed by river systems and roadways, and lowest was from landslides and collapses. The ecologically sensitive areas with more vegetation and a greater distance from roads and woodland are harder to recover from harm. According to the thorough sensitivity analysis, the study region’s high sensitivity area is 1102.36 km2 (26.16%) and the higher sensitivity area is 1177.10 km2 (27.93%). The ecological sensitivity increases from neighborhoods to nature reserves. High-sensitivity areas were in hilly woods and grasslands with few people. The low-sensitivity area was around water and homes. The dynamic stability of the area ecological environment influenced ecological sensitivity. This study aims to provide sustainable land use solutions for the Erhai Lake Basin and a scientific basis for managing and protecting ecologically vulnerable areas.