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High-rise building areas (HRBs) provide significant social and environmental services and play a crucial role in modern urbanization. The large-scale and long-term spatial distribution of HRBs is of great interest to many fields, such as urban planning and local climate analysis. While previous studies have confirmed the value of Sentinel-2 images in extracting HRBs and their changes, current work is limited to relatively local areas and short-term analysis. One reason is due to the fact that the earliest Sentinel-2 image can only date back to 2015. To address this research gap, this paper proposes an efficient procedure to intelligently extract HRBs and their changes from multitemporal Landsat-7 and Sentinel-2 images, using a specifically designed fully convolutional network. To validate the proposed method, we selected four typical cities in China, namely, Beijing, Shanghai, Guangzhou, and Zhengzhou, as study areas. We utilized Landsat-7 images acquired in 2000 and 2010, along with Sentinel-2 images acquired in 2020, as experimental data. We extracted and analyzed three periods of HRBs and their changes in the four cities, along with urban rail terminal data and gross domestic product (GDP) data in the same period. The results show that the proposed method can efficiently extract HRBs and their changes in the four cities over the past 20 years, with an overall accuracy of more than 90%. HRBs changes are primarily driven by urban planning policies and geographical factors. There is a strong positive correlation between the increase in HRBs and the increase in rail terminals, both in terms of quantity and spatial distribution. Additionally, there is a positive correlation between HRBs increase and GDP increase in terms of quantity, but the trend varies in different cities due to their diverse developing modes. Overall, the results indicate that the proposed method can be a potential operational tool to extract large-scale and long-term HRBs and their changes in China. [ABSTRACT FROM AUTHOR]