Recent studies indicate that the Asian Water Tower (AWT) is at risk due to climate change, which can negatively impact water and food security in Asia. However, there is a lack of comprehensive information on lakes' spatial and temporal changes in this region. This information is crucial for understanding the risk magnitude and designing strategies. To fill this research gap, we analyzed 89,480 Landsat images from 1977 ± 2 to 2020 ± 2 to investigate the changes in the size of lakes recharged by the AWT. Our findings showed that out of the 209 lakes larger than 50 km2, 176 (84 %) grew during the wet season and 167 (81 %) during the dry season. 74 % of expanded lakes are located in the Inner Tibetan Plateau (TP) and Tarim basins. The lakes that shrank are found mainly in the Helmand, Indus, and Yangtze basins. Over the entire period, the area of shrinkage (55,077.028 km2 in wet season, 53,986.796 km2 in dry) markedly exceeded expansion (13,000.267 km2 in wet, 11,038.805 km2 in dry), with the drastic decline of the Aral Sea being a major contributor to shrinkage, accounting for 90 % of the total loss. From 1990 ± 2 to 2020 ± 2, alpine lakes mostly expanded, plain lakes mostly shrank, with the opposite trend from 1977 ± 2 to 1990 ± 2. Glacial loss and permafrost thawing under global warming in the Inner TP, Tarim Interior, Syr Darya, and Mekong basins were strongly correlated with lake expansion. However, permafrost discontinuities may prevent significant growth of lakes in the Indus and Ganges basins despite increased recharge. Our findings point to the prominence of the risk the lakes recharged by AWT face. Taking immediate action to manage these risks and adaptation is crucial as the AWT retreats and lake recharges are slowed.