Plateau Pika (Ochotona curzoniae), a key species on the Qinghai-Tibetan Plateau, along with its ecological impact, has been paid extensive attention to. This paper aims to comprehensively assess the ecological impact of pika on vegetation, soil and biodiversity in the Qinghai-Tibet Plateau. Through the review of previous studies, it was found that the foraging behavior of Plateau Pika affected plant community structure and diversity, which decreased plant evenness but increased species richness. Its activities changed soil organic matter, microbial community and greenhouse gas emissions. In terms of animal diversity, it is a food source for many predators and is interdependent with some symbiotic other animals. However, considering pika’s competitiveness with domestic animals for food, population control should be implemented. In order to maintain the ecosystem balance and biodiversity on the Qinghai-Tibet Plateau, self-transmitted contraception control, increasing the planting of non-eating vegetation and controlling the number of livestock and grazing intensity, instead of traditional poisoning method, can be adopted.