Rapid urbanisation causes large urban conversions of natural and agricultural land to non-agricultural use. Research on urban expansion has typically disregarded gradient characteristics. The current study uses slope data calculated based on the Shuttle Radar Topography Mission Digital Elevation Model data set and multi-period land cover data derived from China’s Multi-Period Land Use Land Cover Remote Sensing Monitoring data set to reveal the evolution of spatiotemporal patterns of vertical urban expansion in China from 1990 to 2015. A built-up land climbing index is specifically defined to measure the increasing use of land with slopes. A slope-climbing phenomenon has become increasingly apparent over time. Although built-up land with slopes below 5° accounts for over 85% of the total, this proportion has declined steadily from 89.53% in 1990 to 86.61% in 2015. The number of cities where built-up land was developed on high slopes (over 5°) increased from 150 to 238. Slope-climbing intensity spatially increased from north to south, and showed a “low–high–low” pattern from west to east. In addition, built-up land showed evident slope-climbing trend in areas with high variation in slope. Slope-climbing intensity was high for cities located in mountains and ethnic autonomous prefectures. Lastly, cities going uphill are subjected to the combined effects of natural environmental conditions and social factors. The average slope and population growth have significantly positive impact on slope-climbing intensity.