Objective: To monitor and evaluate the nutritional improvement of primary and middle school students in rural Tibet from 2015 to 2017, and to provide a reference for local nutritional policy. Methods: From 2015 to 2017, 10% of the primary and middle schools in 45 counties implementing the rural nutrition improvement plan in Tibet were selected to carry out nutrition monitoring assessment. The monitoring indicators included growth retardation, emaciation, overweight and obesity, and the percentage comparison was analyzed by chi-square test. Results: A total of 56 674 aged 6-16 students were monitored from 2015 to 2017, and the wasting rate was 11.62%, 9.08% and 8.39%, respectively.Growth retardation rate was 10.27%, 11.87% and 8.99%.The overweight rate was 5.17%, 6.78% and 7.04%.Obesity rate 2.49%, 2.70%, 5.65%. The wasting rate and growth delay rate of rural students in Tibet decreased year by year, while overweight rate and obesity rate increased year by year. The difference between wasting and growth delay prevalence in three years was statistically significant (χ2=122.40, 81.96, P<0.01).The difference between overweight and obesity prevalence within three years also had statistical significance (χ2=665.88,320.74, P<0.01).The emaciation rate of boys and girls monitored from 2015 to 2017 was 11.85% and 7.60, respectively. Growth retardation was 10.71% and 7.70%.The overweight rate was 6.59% and 6.00%.The obesity rate was 3.41%, 3.50%, the wasting rate difference between male and female in three years has statistical significance (χ2=290.25, P<0.01);The growth delay rate difference was statistically significant (χ2=153.63, P<0.01);The difference of overweight rate was statistically significant (χ2=8.33, P<0.01);There was no statistically significant difference in the obesity prevalence(χ2=0.34, P>0.05), since the emaciation rate, growth delay rate and overweight rate of male students were higher than that of female students. From 2015 to 2017, there were statistically significant differences in weight loss, growth delay, overweight and obesity prevalence among students aged 6-16 years old(P<0.05). With the growth of age, the weight loss rate and growth delay rate increased year by year, while the overweight rate and obesity rate decreased with the growth of age. Conclusion The malnutrition (wasting and growth retardation) of Tibetan rural primary and secondary school students has been improved obviously through the nutrition improvement plan, but the excess nutrition is also increasing.