As the "Water Tower of Asia", rivers originating from the Tibetan Plateau provide water resources for more than one billion residents in both its local and surrounding areas. With respect to the essential role that this region plays in terms of water resources in Asia, we provide an overview of the mechanisms governing the water quality, including the major ions and trace elements release, in eleven rivers of the Tibetan Plateau. Overall, the rivers running on the Tibetan Plateau reflect an alkaline aquatic environment, with an average pH of 8.5; and the total dissolved solids (TDS, ~339 mg L^-1) are much higher than the global average value. Over 80% of the water ionic budget in the rivers of the plateau is comprised of Ca²⁺, Mg²⁺, HCO₃^- and SO₄^2-. The main mechanisms that control the river water chemistry on the Tibetan Plateau are natural processes and present a visible spatial heterogeneity. For instance, in rivers of the southern Tibetan Plateau, the water quality is mainly controlled by the rock-weathering, while rivers of the central and northern Tibetan Plateau are also largely affected by evaporation-crystallization processes. In general, most of the rivers on the Tibetan Plateau are uncontaminated and still in a pristine condition. However, it should be noted that due to the natural process such as rock-weathering and groundwater leaching, and anthropogenic activities such as urbanization and mining operations, the concentrations of several toxic elements (e.g., As, Cd, Pb, Mn, Hg and Tl) in some of the basins are higher than the China national standard (GB) and the World Health Organization (WHO) guidelines for drinking water. With increasing anthropogenic activities on the plateau and changes in the river basins, it is necessary to conduct the long-term monitoring of the river water chemistry of this climate-sensitive and eco-fragile region.