To better understand the recent wide-scale changes in glacier coverage, we created and compared two glacier inventories covering eastern Nepal, based on aerial photographs (1992) and high-resolution Advanced Land Observing Satellite (ALOS) imagery (2006–10). The ALOS-derived inventory contained 1034 debris-free and 256 debris-covered glaciers with total and average areas of 440.2 ± 33.3 and 0.42 km2 and 1074.4 ± 206.4 and 4.19 km2, respectively. We found that the debris-free glaciers have lost 11.2% (0.7 ± 0.1% a−1) of their area since 1992, whereas the number of glaciers increased by 5% because of fragmentation. The area change was significantly correlated by simple linear regression with minimum elevation (r = 0.30), maximum elevation (r = −0.18), altitudinal range (r = −0.50), glacier area (r = −0.62) and mean slope (r = 0.16), confirming that larger glaciers tended to lose a larger area (but a smaller percentage) than smaller glaciers. The intra-regional analysis of the glacier changes clearly showed higher shrinkage rates in the western massifs compared with the eastern massifs. In addition, 61 small glaciers covering an area of 2.4 km2 have completely disappeared since 1992.