To explore the responses of vegetation growth to change in terrestrial water storage in Southwest China, we analyzed the change trend and relationship between vegetation and terrestrial water storage anomaly (TWSA) in Southwest China from January 2003 to December 2021 by using TWSA data of Gravity Recovery and Climate Experi-ment (GRACE) satellite and normalized differential vegetation index (NDVI) data. The results showed that NDVI in Southwest China during the study period showed an overall upward trend. Meanwhile, TWSA showed a significant downward trend in central and southern Tibet, and a significant upward trend in northwest Tibet and southeast region of Southwest China. Results of Pearson correlation analysis showed that there were significant spatial differences in responses of NDVI to TWSA changes in Southwest China. NDVI had a significant negative response to TWSA changes in most regions of Tibet, but a significant positive response to TWSA changes in most regions of southeast region of Southwest China. Such differences were driven by climate change and topography.