Objective: To understand the relationship between lipid metabolism and heart rate deflection point (HRDP) in Tibetan children in the high altitude area of Ganzi, and to provide reference for effective obesity prevention and physical exercise intervention for Tibetan children. Methods: From September to October 2019, 284 Tibetan primary school students living in Ganzi area were randomly selected. HRDP and deflection point speed with different body mass index (BMI) by increasing load method, as well as serum lipid metabolism were assessed. The correlation between the HRDP and lipid metabolism level was analyzed. Results: There were statistically significant differences in serum leptin, adiponectin, total cholesterol, and triglyceride levels among the first and second grade Tibetan primary school students in the Ganzi high altitude area with different nutritional status ( F =22.16, 10.12, 11.24, 4.35, P <0.05). The heart rate values at the HRDP in the first and second grades, the third and fourth grades, and the fifth and sixth grades under different nutritional status were compared, and the differences were statistically significant ( F =3.35, 4.76, 4.68, P <0.05). Pearson correlation analysis showed that there were statistically significant correlations between HRDP and serum leptin in the obese, overweight, normal, and lean groups in the first and second grades of primary school ( r =0.66, 0.14, 0.45, 0.65 , P <0.05). Conclusion There is a close relationship between HRDP and lipid metabolism of Tibetan children in the high altitude area of Ganzi, and the heart rate at the deflection point can be used as an effective reference intensity for exercise intervention in plateau children.