Understanding the driving mechanisms of forest changes is of great significance for developing effective adaptation strategies to mitigate the impacts of climate change and human activities on ecosystems. This study used Theil–Sen median trend analysis, Mann–Kendall test, contribution rate decomposition, partial least squares, geodetector and residual analysis to explore the impact of climate change and human activities on the forest coverage area and NDVI of the Altai Mountains. Results show that changes in forest cover are driven by both forest management policies and climate change. Among them, forest management policy is the main factor. However, there are differences in the driving mechanisms in different altitude zones: in the alpine and subalpine zones, the promoting effects of natural death and climate change bring the forest coverage area toward a dynamic balance, while under the combined effects of human activities and climate change, the forest coverage area in the low mountain zones shows an expansion trend. For forest NDVI, the analysis results of the six scenarios show that the joint action of climate change and human activities promotes the growth of forest NDVI in the largest proportion (50.20%); the impact of climate change on forest NDVI is greater than that of human activities, and most of it is a promotion effect (30.28%). Forest degradation is mainly caused by human activities (19.39%), especially in the edge areas of the forest. Among climate factors, precipitation and snowmelt water are the main controlling factors for forest growth. Snowmelt water from March to April is an important water source before the growing season. This study provides the important scientific basis for forest management and strategic planning in the Altai Mountains.