The Qinghai–Tibet railway is the plateau permafrost railway with the highest altitude and the longest line in the world. The natural conditions along the line are harsh, with many unfavorable factors such as low temperature, strong ultraviolet radiation, and large changes in daily temperature, resulting in frequent bridge damage. In order to study the bridge temperature field and its effect in the permafrost region of the Qinghai–Tibet railway, a long-term field test was carried out, and a calculation model of sunshine temperature field of concrete two-piece T-beam was established based on the principle of meteorology and heat transfer. On this basis, the beam temperature difference load mode, beam section temperature distribution law, and temperature effect were obtained. As revealed, the daily temperature difference of the Qinghai–Tibet railway bridge is large in winter, which is related to the ground’s effective radiation and surface reflectivity, and the maximum value has exceeded the current codes. The beam section temperature field shows “internal heat and external cold” in the morning and “internal cold and external heat” from noon to evening. Under the action of strong radiation and large temperature difference, bridge displacement occurs frequently, by which it is easy to cause damage to rail fasteners and bridge bearings. Based on the field test and finite element analysis, the bridge temperature difference load mode was proposed, which makes up for the deficiency that the relevant codes do not consider the plateau’s special climatic conditions and can provide a reference for the construction of plateau railways such as the Sichuan–Tibet railway.