The Qiangtang Basin is a significant prospective area for hydrocarbon and gas hydrate resources in the Tibetan Plateau, China. However, relatively little work has been performed to characterise heat flow in this basin, which has restricted petroleum and gas hydrate exploration. In this study, we compare present and palaeo-heat flow in the Qiangtang Basin to provide information on geothermal regime, hydrocarbon generation and permafrost that is necessary for further petroleum and gas hydrate exploration. We base our study on temperature data from a thermometer well, thermal conductivity tests, vitrinite reflectance data, homogenisation temperature data from fluid inclusions, stratigraphic information and a time-independent modelling approach. Our results indicate that in the central Qiangtang Basin, the present thermal gradient is approximately 15.5 °C/km, and heat flow is approximately 46.69 mW/m2. Heat flow in the Qiangtang Basin is not relatively stable since the Early Jurassic, as previous research has suggested, and it is generally decreasing with time. Additionally, there is a clear difference between the hottest thermal regime of the southern and northern Qiangtang Depressions during Cretaceous to Pleistocene time. In the southern Qiangtang Depression, the palaeogeothermal gradient is approximately 32.0 °C/km, and palaeo-heat flow is approximately 70 mW/m2. However, in the northern Qiangtang Depression, the palaeogeothermal gradient exceeds 81.8 °C/km, and palaeo-heat flow is greater than 172.09 mW/m2. The high thermal regime in the northern Qiangtang Depression is driven mainly by hydrothermal convection. Gas reservoirs are possible targets for hydrocarbon exploration in this depression. Currently, the northwestern part of the northern Qiangtang Depression is the most favourable area for gas hydrate exploration in the Qiangtang Basin.