High-altitude mountainous counties face compound geological hazards and chronic socioeconomic and ecological pressures, yet existing resilience assessments rarely integrate external disturbance, internal adaptive capacity, and subsystem coordination within a dynamic county-level framework. Taking 73 medium- and high-altitude counties in Sichuan Province, China, as the study area, this study develops an EDE–TA–CCD framework that combines Environmental Disturbance Exposure, Total Adaptive Capacity, and Coupling Coordination Degree. Using panel data from 2007 to 2022, an improved coupling coordination model, spatial autocorrelation analysis, and K-means clustering were applied to examine the spatiotemporal evolution, spatial dependence, and typological differentiation of geological disaster resilience. The results show that regional resilience improved overall during the study period, mainly driven by the continuous enhancement of TA and CCD, while EDE remained relatively stable. Spatially, resilience displayed significant clustering and path dependence, with higher resilience concentrated in counties with stronger development foundations and reconstruction support, and lower resilience persisting in remote mountainous areas. Static classification and dynamic trajectory analysis further identified three resilience patterns and five evolutionary pathways, revealing differentiated processes such as low-level lock-in, stable saturation, post-disaster remodeling, rapid catch-up, and high-pressure stress climbing. The proposed framework provides a practical tool for identifying resilience disparities and supporting differentiated disaster risk governance in high-altitude mountainous regions.