The Three-River Source Region (TRSR) is an important area for the ecological security of China. Vegetation growth has been affected by the climate change, topography, and human activities in this area. However, few studies have focused on analyzing time series tendencies of vegetation change in various terrain conditions. To address this issue in the TRSR, this study explored vegetation stability, tendency, and sustainability with multiple methods (e.g., coefficient of variation, Theil-Sen median trend analysis, Mann-Kendall test, and Hurst index) based on the 2000–2017 Global LAnd Surface Satellite Leaf Area Index (GLASS LAI) product. The differentiation patterns of LAI variations and multiyear mean LAI value under different topographic factors were also investigated in combination with digital elevation model (DEM). The results showed that (1) the mean LAI value in the study area increased, with a linear tendency of 0.013·10 a−1; (2) LAI values decreased from southeast to northwest in terms of spatial distribution and the CV indicated LAI variations were relatively stable; (3) the trend analysis revealed that the improved area of LAI accounted for 62.72% which was larger than the degraded area (37.28%), and hurst index revealed a weak anti-sustaining effect of the current tendencies; and (4) the increasing trend was found in multiyear mean LAI value as relief amplitude and slope increased, while LAI stability improved with increasing slope. They exhibited a clear regular pattern. Moreover, significant improvement in LAI generally occurred in low-altitude and flat areas. Finally, the overall improvement and sustainability of LAI improved when moving from sunny aspects to shady aspects, but the LAI stability decreased. Note that vegetation degradation was observed in some high slope areas and was further aggravated. This study is beneficial for revealing the spatial and temporal changes of LAI and their changing rules as a function of different topographic factors in the TRSR. Meanwhile, the results of this study provide theoretical support for sustainable development of this area.