Investigating erosion and river sediment yield in high-mountain areas is crucial for understanding landscape and biogeochemical responses to environmental change. We compile data on contemporary fluvial suspended sediment yield (SSY) and 12 environmental proxies from 151 rivers in High Mountain Asia surrounding the Tibetan Plateau. We demonstrate that glaciers exert a first-order control on fluvial SSYs, with high precipitation nonlinearly amplifying their role, especially in high–glacier cover basins. We find a bidirectional response to vegetation’s influence on SSY in the Eastern Tibetan Plateau and Tien Shan and identify that the two interacting factors of precipitation and vegetation cover explain 54% of the variability in SSY, reflecting the divergent roles of vegetation in promoting biogenic-weathering versus slope stabilization across bioclimatic zones. The competing interactions between glaciers, ecosystems, and climate in delivering suspended sediment have important implications for predicting carbon and nutrient exports and water quality in response to future climate change.