Objective To unveil the current situation and bends of Keshan disease in Pingliang city of Gansu province, to evaluate the outcome of related prevention and control measures, and to provide scientific basis for further prevention and treatment of the disease. Methods According to the "the central allowance local public health special funds endemic disease prevention programs grams mountain monitoring programme" and "the diagnostic criteria for Keshan disease" (GB 17021-1997), between 2007 and 2009, local residents from nine monitoring points in Pingliang city of Gansu province were clinically examined, and electrocardiography(ECG) tracings and Xray were taken of suspected cases. Corn, wheat samples and hair samples of children, adults and women were collected, and selenium content of these samples was determined by 2.3-2-amino-naphthalene fluorescence method. Results A total of 5846 residents were surveyed in 3 years, 247 cases of Keshan patients were detected, with a detection rate of 4.23%(247/5846), of which potential cases of Keshan disease 214, the detection rate was 3.66% (214/5846); chronic Keshan disease 33 cases, the detection rate was 0.56% (33/5846); no acute type and subacute Keshan disease detected. A total of 764 abnormal ECG cases were detected, and abnormal detection rate was 13.07%(764/5846). Two hundred and seven cases of suspected patients were examined by chest X-ray, 80 cardiac enlargement cases were detected, the detection rate was 38.6% (80/207). The 262 hair samples of children, adults and women were analyzed, hair selenium was (0.279 ± 0.098)mg/kg. Of the 9 corn and 31 wheat samples collected, corn selenium was (0.0079 ± 0.0029)mg/kg; wheat selenium was (0.0104 ± 0.0078)mg/kg. Conclusions Overall Keshan disease is in a stable and subsided trend in Pingliang city of Gansu province, but there are still a number of potential chronic types, sporadic new cases, suggesting that the disease monitoring, comprehensive prevention and treatment of the patients are the focus.