Objective: To explore the relationship between sleep quality with depression and anxiety symptoms among college students in Tibet plateau areas, and to provide scientific basis for sleep quality promotion, as well as depression and anxiety allevation in high-altitude areas. Methods: The stratified cluster sampling method was used to investigate 1 288 second and third year college students in Tibet University from October to November 2019. The Chinese Version of Pittsburgh Sleep Quality Index(PSQI), Self rating Depression Scale (SDS) and Self rating Anxiety Scale (SAS) were used in this survey, and the survey results were tested by t-test, variance analysis and Logistics regression analysis. Results: The mean sleep quality index was(5.32±2.94), and 20.5% (n=264) of participants reported poor sleep quality. The detection rates of depression and anxiety symptoms were 46.0% (n=592) and 24.4%(n=314), respectively. And 20.4% (n=263) had the worst sleep quality with the coexistence of depression and anxiety symptoms. College students who are female, Tibetan, smoking, drinking and poor sleep quality have a higher risk of depression(OR=1.55,1.80,1.51，1.67，5.60), while Tibetan, drinking and poor sleep quality college students have a higher risk of anxiety(OR=1.52,1.91，10.22)(P<0.05). Conclusion There is a close relationship between the sleep quality of college students in Tibet Plateau areas with depression and anxiety symptoms. Mental health education department in colleges should attach great importance to the sleep quality of students, especially for individuals with sleep disorders, so as to reduce the incidence of depression and anxiety symptoms among college students.