<p>The conservation of Outstanding Universal Value (OUV) constitutes the core objective of World Natural Heritage protection. However, systematic research integrating geomorphological conservation with tourism development in karst heritage sites remains limited. Based on a systematic literature review, this study establishes an analytical framework characterized as “theory-driven, evidence-supported, and scientifically deepened.” We synthesize the current research status regarding geomorphological conservation and tourism development, outline major scientific advances, and distill six critical scientific questions that require urgent attention. This work aims to provide a theoretical foundation and practical guidance for the scientific management and sustainable development of karst World Natural Heritage sites and analogous natural protected areas. The findings also support the achievement of the United Nations Sustainable Development Goals through improved conservation of karst ecosystems.</p> Graphical Abstract <p></p>