Understanding the spatiotemporal patterns of three-dimensional urban forms, especially building height, can have important implications for improving urban air quality and mitigating the urban heat island effect by optimizing urban planning and management policies. This study investigated building height evolution and its influencing factors over approximately half a century (1960–2017) in Guangzhou, China. The results indicated that the logarithmic declines in height, quantity, and area of urban buildings followed Zapfs law, which restricts the three-dimensional shape of the urban form. The urban building height decreased from the center to the periphery of the city and decreased with decreasing altitude and increasing distance from main roads. These characteristics constituted the three main spatial differentiation rules of building height in the central district of Guangzhou, and all exhibited a logarithmic decrease, which gradually strengthened over time. The development of a double-layered height structure of low-rise and high-rise buildings between 1990 and 2017 was a notable manifestation of the increase in vertical urban height over time. The three factors of city center, altitude, and accessibility, which represent centrality, low relief, proximity to water, and proximity to road networks, highlighted the roles of traffic accessibility and commercial attraction in building height evolution. The importance of location macroscopically depends on the combined effect of the geographical pattern, urban planning, and market forces of cities located on a plain near hill or by a river. The principle of profit orientation restricted spatiotemporal building height patterns.