Urban progression influences water conservation by altering surface characteristics and local climate regimes, potentially posing significant risks to water sustainability and ecological integrity. Since 2015, the Chinese government has championed a new development philosophy aimed at promoting harmonious coexistence between human and nature. Based on the green connotation of the new development philosophy, this study simulated the spatial and temporal distribution of water conservation in five plateau lakeside cities (Plateau Lakeside City-PLC: Dianchi Lake Basin-DCB, Fuxian Lake Basin-FXB, Erhai Lake Basin-EHB, Qilu Lake Basin-QLB and Xingyun Lake Basin-XYB), established a comprehensive framework of indicators affecting water conservation, and quantified the changes in the drivers of water conservation. The results indicated that, except for DCB, the spatial distribution of water conservation in PLC exhibits similarity, but overall demonstrates a declining trend over time. The average importance of the factors in the PLC was weighed using Geodetector’s q value. The most critical factors affecting water conservation in PLC included climate change (precipitation: q_PRE=0.66; evaporation: q_ET=0.57) and land cover (q_LC=0.45). In addition, the topography (slope: q_SLOPE=0.39; elevation: q_DEM=0.43), vegetation coverage (q_NDVI=0.30), and soil (plant available water content: q_PAWC=0.38; root restricting layer depth: q_ROOT=0.18) were influential factors followed climate change and land cover. Among the social factors, population density (q_POP=0.37) has a small impact on water conservation, while economic activities and human-related land activities (q_CROP,q_NTL, and q_CITY are all less than 0.1) do not show a significant impact, due to the government’s implementation of the new development philosophy, which balances development and conservation.