［Objective］ Spatiotemporal changes in ecosystem health under different land-use scenarios in Qinghai Province were analyzed， and the specific impacts of land-use change on ecosystem health under different natural and anthropogenic disturbances were quantitatively assessed to provide theoretical support for ecological protection and high-quality development in the province. ［Methods］ Based on the VORS and GMMOP-PLUS models， the evolutionary pattern of ecosystem health in Qinghai Province from 2005 to 2020 was investigated， and the extent of the impacts of land-use changes on ecosystem health under four development scenarios were simulated. ［Results］ ① The spatial distribution of ecosystem health in Qinghai Province showed a pattern of low values in the northwest， moderate values in the southwest， and high values in the east. From 2005 to 2020， the ecosystem health index decreased from 0.292 to 0.252， with significant declines in the southeastern regions and Qaidam Basin. Rapid expansion of cultivated and construction land has led to the destruction of ecosystem structures， thereby affecting ecological health. ② Using the GMMOP-PLUS model， land use changes under four development scenarios for 2030 were simulated： Natural Development （ND）， Ecological Protection （EP）， Urban Development （UD）， and Comprehensive Development （CD）. Construction land increased to varying degrees in all scenarios， with the largest increases observed for UD and CD scenarios （3.72×10⁴ hm²）， concentrated around Xining City and expanding to Gonghe County， Delingha City， and Golmud City. Under the EP scenario， the ecological land was effectively protected， with the proportion of forest and wetland areas reaching a maximum of 7.54%. ③ Among the four scenarios， the EP scenario showed the highest ecosystem health index （0.256）， indicating that the effective implementation of ecological protection measures， such as safeguarding forest and wetland areas， significantly improved patch and landscape connectivity， thereby enhancing ecosystem health and service functions. ［Conclusion］ Spatially intensive utilization is a key strategy for improving ecological health， particularly in regions experiencing rapid urbanization. Specific measures include the rational planning of construction land， restricting land expansion， enhancing the connectivity of ecological land， and strengthening ecological protection and restoration to promote the recovery and long-term stability of ecosystems.