[Objective] To clarify the process of runoff and sediment production on the upper and lower slopes of construction access roads under vegetation recovery conditions, and to reveal the impact of vegetation recovery after the disturbance caused by the construction of access roads on soil and water loss at the slope scale in the ecologically fragile subalpine forest and shrub area of southeastern Tibet. [Methods] Typical slopes under different vegetation recovery conditions after the disturbance on the upper and lower slopes of the construction access roads were selected for indoor simulated rainfall experiments. The study investigated the process of runoff and sediment production under four types of vegetation coverage (0%, 30%, 60%, 90%), three slopes (15°, 30°, 45°), and two rainfall intensities (30 mm/h, 60 mm/h) after engineering disturbance, to clarify the impact of vegetation recovery of construction access roads on soil and water loss. [Results] (1) After the engineering disturbance of the construction access roads, vegetation recovery on the bare slopes of the upper and lower slopes effectively delayed the initial runoff time, and this effect became more pronounced with increasing vegetation coverage, especially on the upper slopes. (2) Within the range of 0% to 60% vegetation coverage, the stable runoff rate on both upper and lower slopes significantly decreased with the increase of vegetation coverage, with the stable runoff rate of 60% and 90% vegetation coverage being close. Compared to bare slopes, the runoff reduction benefits of 60% and 90% vegetation coverage were 59%–75% and 58%–77% respectively, indicating that the critical vegetation coverage for runoff reduction is 60%. (3) The sediment reduction benefits at 30% and 60% vegetation coverage reached 29%–82% and 86%–96% respectively. Below 60% vegetation coverage, the sediment reduction effect significantly increased with the increase in coverage; beyond this critical threshold, even with increased coverage, the sediment reduction benefits showed little change. (4) Under the same vegetation coverage, slope, and rainfall intensity conditions, the total runoff volume from the upper slopes formed by excavation was always higher than that from the lower slopes formed by filling, while the total sediment yield from the lower slopes was always higher than that from the upper slopes, reflecting significant differences in soil erosion on the slope surface after the disturbance of the construction access roads between excavation and filling slopes. [Conclusion] In the prevention and control of soil and water loss in the disturbed areas of construction access roads in southeastern Tibet, a 60% vegetation recovery rate offers both good control benefits and economic feasibility. In the layout of soil and water conservation measures, more emphasis should be placed on "controlling water" for excavation slopes and on "blocking sediment" for filling slopes. Only by fully considering these differences can better soil and water conservation effects be achieved in disturbed areas of construction access roads.