Abstract: Objective To explore the usage and effectiveness of the antihypertensive drugs in three counties or districts in Tibet Autonomous Region in China. Methods Surveys on the prevalence of major cardiovascular disease were conducted in Linzhi county（altitude 3000meters）,Chengguan district of Lasa city（altitude 3650meters）and Anduo county（altitude 4700meters）from 2014 to 2016. One thousand residents were randomly selected from each county（district）and the information on cardiovascular disease,related risk factors and drug usage data was collected. The antihypertensive drug usage and effectiveness of the hypertensive patients were analyzed. Results A total of 490 hypertensive patients were identified during the surveys,148 were from Linzhi county,190 from Chengguan district and 152 from Anduo county. For the three counties（district）,the proportions of the patients taking antihypertensive drugs regularly in the nearest two weeks were all below 40.0%and the control rates of hypertension for these patients were all below 50.0%. The drugs used most frequently were Tibetan and Chinese herbs,which accounted for 36.84% of all the drugs used.In Chengguan district,72.55% of the patients took only Tibetan herbs and the control rate of hypertension for the patients taking antihypertensive drugs in the nearest two weeks was15.7%. Conclusion The situation is not ideal for the drug therapy of hypertension in Tibet. It is needed to carry out extensive research on the drug therapy and to promote the standardized treatment and management of hypertensive patients in Tibet.