Abstract: Salt lake lithium (Li) resources are a key source of global Li supply, and their green development is of great significance for achieving the goal of energy transition. Salt lakes possess dual attributes: they function both as plateau salt lake mines and as natural lakes, and their ecological and environmental concerns cannot be overlooked. In recent years, Li extraction activities in several salt lakes across the Qinghai-Xizang Plateau of China have entered a stage of rapid development. Meanwhile, Li extraction technologies are transitioning from conventional solar evaporation methods to direct lithium extraction (DLE) technologies, including adsorption, membrane separation, and electrochemical processes. However, the operation of these complex processes has raised growing concerns, primarily regarding the hydrochemical balance and the discharge of pollutants back into the lake. Based on typical Li extraction process flows, the DLE process can be divided into four key stages: pretreatment, separation and extraction, deep purification, and lithium precipitation. Existing studies are systematically reviewed to synthesize the environmental impacts associated with each process stage of DLE, while the regional environmental effects of salt lake development are further analyzed from a macro perspective. The results indicate that solar evaporation is a major driver of salt lake shrinkage. In contrast, improper management of process wastewater and residual brine in DLE operations may lead to localized pH fluctuations and introduce risks of heavy metal contamination when discharged back into the lake, thereby threatening the safety of salt lake aquatic ecosystems. To realize the green and sustainable exploitation of salt lake Li resources, the conventional solar pond precipitation process should be upgraded toward an integrated "pre-concentration+DLE" model. Low-environmental-impact technologies, including electrochemical intercalation and deintercalation, bipolar membrane electrodialysis, and mechanical vapor recompression (MVR) evaporation crystallization, should be promoted. In addition, a full-process pollutant generation and discharge inventory should be established to strengthen quantitative identification of pollution characteristics. A negative list of pollutants discharged back to salt lakes should be formulated based on toxic effects of key species, and management strategies for residual brine returning to lakes should be optimized.