Objective To analyze current status of chronic progression of hepatitis B virus (HBV) infection and its related diseases among Tibetan population in Ngari Prefecture of Tibet,and explore influencing factors for prognosis. Methods Clinical data of 2 043 Tibetan patients in Ngari Prefecture People's Hospital from March 2016 to March 2018 were selected, status of positive rate of HBsAg, hepatic cirrhosis, and hepatocellular carcinoma due to chronic progression of hepatitis B were analyzed, multivariate logistic regression was used to analyze the influencing factors for poor outcomes of liver disease due to progression of hepatitis B in Ngari Prefecture. Results The overall positive rate of HBsAg was 18.01% (368/2 043) in Tibetan population of Ngari Prefecture, positive rates of HBsAg were 17.13% (185/1 080) in males and 19.0% (183/963) in females, with no significant difference (χ²=1.213, P>0.05);positive rate of HBsAg in farmers and herdsmen was 23.26% (217/933), which was higher than 13.60% (151/1 110) of urban residents (χ²=31.91,P<0.05). Among HBsAg positive population, 64.13% (n=236), 16.58% (n=61), 10.60% (n=39), and 8.70% (n=32) were with hepatitis, compensated cirrhosis, decompensated cirrhosis, and primary hepatocellular carcinoma respectively. Patients at the age of 40-49 years had the peak incidence of compensated cirrhosis, and at the age of 50-59 years had the peak incidence of decompensated cirrhosis and primary hepatocellular carcinoma. Multivariate unconditional logistic regression analysis showed that age ≥ 50 years, HBsAg positive in patients' mothers, lack of knowledge of hepatitis B, drinking, irregular living habits and irregular treatment were influencing factors for hepatitis B progressed to decompensated cirrhosis and primary hepatocellular carcinoma in patients in Ngari Prefecture (all P<0.05, all OR>1). Conclusion Positive rate of HBsAg in Tibetan population in Ngari Prefecture is high, the progress of chronic disease is rapid, and incidence of poor outcome of liver disease is high. Prevention and intervention, especially antiviral treatment and follow-up mana-gement of HBV carriers and hepatitis B patients should be further strengthened.