Objective To assess the endemic trend of Kaschin-Beck disease in Tibet and to provide scientific basis for prevention and etiology study of the disease. Methods A questionnaire designed by us was administered to 905 participants who were from Lhundrop county, Medro Gongkar county of Lhasa municipality and Sangri county of Lhoka region in July to November, 2007. The Kashin-Beck disease diagnostic criteria(GB 16003-1995) was used for clinical diagnosis, and children 5 to 14 years old were taken right wrist X-ray film for diagnosis.Results One hundred and forty-four genealogies were recruited in this study. The interview and clinical examination were done to 905 persons, 208 persons were detected with Kaschin-Beck disease, and the detectable rate was 22.98%(208/905). The numbers of patients with degrees Ⅰ , Ⅱ and Ⅲ of Kaschin-Beck disease were 148, 43 and 17, respectively, with proportion of 71.15%(148/208), 20.67%(43/208) and 8.17%(17/208) out of all patients, respectively. The detectable rates of Kaschin-Beck disease were 29.73% (102/343) and 18.86%(106/562), respectively in Lhasa and Lhoka district, and the difference between this two districts was statistically significant(x2= 15.257, P＜ 0.01) . A total of 368 males and 537 females were recruited in this study, the detectable rates of male and female with Kaschin-Beck disease were 19.29% (71/368) and 25.51% (137/537), respectively,and the difference between male and female was statistically significant (x2 = 5.372, P ＜ 0.01) . In this study most patient were between 31 to 70 years old, the patients with degrees Ⅱ or Ⅲ of Kaschin-Beck disease were mostly above 40 years old. There were only 5 patients who were less and equal 20 years old in chinical diagnosis. The Xray positive detectable rate of children between 5 to 14 years old was 6.85% (10/146). Conclusions The condition of Kashin-Beck disease area is relatively stable in these two regions in recent years, and shows a downward trend. However, there are still positive child cases diagnosed by X-ray, which should arouse the attention of the relevant departments to further strengthen the implementation of control measures.