Abstract: To address reverse power flow, voltage violation, and photovoltaic and hydropower curtailment caused by the simultaneous integration of distributed photovoltaics and small hydropower in mountainous distribution networks, a hierarchical hydropower-photovoltaic-storage coordinated consumption and multi-objective optimization method is proposed. The method constructs a multi-level framework consisting of micro-level local consumption in distribution transformer areas, meso-level regional mutual support, and macro-level coordination between the main grid and distribution network. An optimization model considering photovoltaic and hydropower curtailment rates, voltage deviation, and operating cost is established. A 24 h typical daily case study is conducted for verification. After coordinated optimization, the maximum node voltage decreases from 1.031 p.u. to 1.014 p.u., the minimum node voltage increases from 0.952 p.u. to 0.982 p.u., the average voltage deviation decreases by 56.25%, and the photovoltaic and hydropower curtailment rates are reduced by about 50.0% and 45.7%, respectively. The results show that the proposed method improves renewable energy consumption capacity and operational economy.