Scientifically assessing the interaction between urbanization and eco-environment in the Tibetan Plateau is critical for optimization of urbanization speed and quality, and for the restoration and improvement of the eco-environment. Based on previous studies about the interaction between urbanization and eco-environment in the Tibetan Plateau, we established complete analysis models to examine the overall process, including comprehensive evaluation index analysis, coupling coordination degree measurement, coupling type identification, decoupling path exploration, and future trend prediction. We used a multi-scale comparison analysis method to clarify the differences between scales (across the Tibetan Plateau and its provinces and prefecture-level cities), identify the problem regions, and propose customized improvement measures. Here we show that the comprehensive evaluation index of urbanization has experienced a staged upward trend in different scales, and the overall urbanization index of Qinghai is higher than that of Tibet. However, the changing trends of the eco-environment index are different. The changes in eco-environment index of Qinghai show a decreasing trend, whereas Tibet's changes tend to be stable. The eco-environment index of prefecture-level cities is stratified. We also found that the changing trends of coupling coordination degree of urbanization and eco-environment in different scales were overall rising. The coupling type has changed from imbalanced recession type to nearly imbalanced recession type, and finally to grudgingly coordinated development type. However, most of these types are lagged urbanization types. The alternate change trend between strong decoupling and weak decoupling indicates a negative interaction between urbanization and the eco-environment at different scales. Thus, it can be inferred that the lagged urbanization is a prominent phenomenon. The result of predication shows that in the next 10 years the coupling coordination degree of urbanization and eco-environment will increase steadily in all geographic units, but there will be a gap in the growth rate.