Vegetation, being a core component of ecosystems, is known to be influenced by natural and anthropogenic factors. This study used the annual mean Normalized Difference Vegetation Index (NDVI) as the vegetation greenness indicator. The variation in NDVI on Hainan Island was analyzed using the Theil–Sen median trend analysis and Mann–Kendall test during 2000–2019. The influence of natural and anthropogenic factors on the driving mechanism of the spatial pattern of NDVI was explored by the Multiscale Weighted Regression (MGWR) model. Additionally, we employed the Boosted Regression Tree (BRT) model to explore their contribution to NDVI. Then, the MGWR model was utilized to predict future greenness patterns based on precipitation and temperature data from different Shared Socioeconomic Pathway (SSP) scenarios for the period 2021–2100. The results showed that: (1) the NDVI of Hainan Island forests significantly increased from 2000 to 2019, with an average increase rate of 0.0026/year. (2) the R2 of the MGWR model was 0.93, which is more effective than the OLS model (R2 = 0.42) in explaining the spatial relationship. The spatial regression coefficients of the NDVI with temperature ranged from −10.05 to 0.8 (p < 0.05). Similarly, the coefficients of Gross Domestic Product (GDP) with the NDVI varied between −5.98 and 3.28 (p < 0.05); (3) The natural factors played the most dominant role in influencing vegetation activities as a result of the relative contributions of 83.2% of forest NDVI changes (16.8% contributed by anthropogenic activities). (4) under SSP119, SSP245, and SSP585 from 2021 to 2100, the NDVI is projected to have an overall decreasing pattern under all scenarios. This study reveals the trend of greenness change and the spatial relationship with natural and anthropogenic factors, which can guide the medium and long-term dynamic monitoring and evaluation of tropical forests on Hainan Island.