OBJECTIVE To understand the epidemic status of alveolar echinococcosis in Tibetan children in south Qinghai Province. METHODS The imageology and serology methods were applied to investigate the epidemic status of alveolar echinococcosis of elementary school students in Yushu and Guoluo prefectures. RESULTS Totally 19 629 children were investigated by the portable B ultrasound and 221 children were diagnosed as alveolar echinococcosis with the morbidity of 1.13%. Totally 9 888 were investigated by the indirect ELISA, and the positive rate of serum tests was 12.59% (190/9 888). The total morbidity of alveolar echinococcosis of children in Yushu Prefecture was 0.42% (31/7 454) and it was 1.57% (190/12 175) in Guoluo Prefecture and there was a significant difference between them (χ2 = 53.42, P＜0.005). The sero-positive rates of children in Yushu and Guoluo were 4.26% (302/7 081) and 18.56% (1 835/9 888), respectively (χ2 = 765.77, P＜0.005). The counties with the highest prevalence of alveolar echinococcosis in children were Dari County (4.31%, 106/2 461) and Banma County (1.92%, 26/1 351) of Guoluo Prefecture, and Chengduo County (1.11%, 18/1 612) of Yushu Prefecture. The total morbidity rates of alveolar echinococcosis of male and female children were 0.91% (91/9 954) and 1.34% (130/12 175) respectively (χ2 = 7.35, P＜0.005). The total sero-positive rates of alveolar echinococcosis of male and female children were 12.10% (1 037/8 568) and 13.09% (1 100/8 406) respectively (χ2 = 3.63, P＞0.05). The total morbidity of alveolar echinococcosis of children in different age groups was from 1.00% to 1.13%, and there was no significant difference among the age groups (χ2 = 2.73, P＞0.05). The P1a type, P1b type and P2 type accounted for 67.76% (145/214), 10.75% (23/214) and 16.36% (35/ 214) respectively among the alveolar echinococcosis patients. The diameters of nidus of 87.38% (187/214) patients were less than 5 cm, and 2.80% (6/214) were more than 10 cm. CONCLUSIONS The epidemic status of alveolar echinococcosis of Tibetan children in south Qinghai Province is serious, but most of the patients were at early stage of the disease. The screening work of alveolar echinococcosis should be strengthened in Tibetan children, so as to perform the early diagnosis and treatment.