Glaciers in High Mountain Asia have experienced heterogeneous rates of loss since the 1970s. Yet, the associated changes in ice flow that lead to mass redistribution and modify the glacier sensitivity to climate are poorly constrained. Here we present observations of changes in ice flow for all glaciers in High Mountain Asia over the period 2000–2017, based on one million pairs of optical satellite images. Trend analysis reveals that in 9 of the 11 surveyed regions, glaciers show sustained slowdown concomitant with ice thinning. In contrast, the stable or thickening glaciers of the Karakoram and West Kunlun regions experience slightly accelerated glacier flow. Up to 94% of the variability in velocity change between regions can be explained by changes in gravitational driving stress, which in turn is largely controlled by changes in ice thickness. We conclude that, despite the complexities of individual glacier behaviour, decadal and regional changes in ice flow are largely insensitive to changes in conditions at the bed of the glacier and can be well estimated from ice thickness change and slope alone.