Abstract: Objective To examine the prevalence and risk factors of alcoholic liver disease(ALD) among native Tibetan adults in Lhasa city.Methods With cluster sampling method, 2178 native Tibetan residents aged 18 years or above were recruited for a survey including questionnaire interview, physical examination, and type-B ultrasound test.Results The overall prevalence rate of ALD among the participants was 4.87%, with 67 hepatitis cases, 34 fatty liver cases, and 5 cirrhosis cases, accounting for 63.21%, 32.08%, and 4.72% of all ALD cases, respectively.The results of multivariate unconditionl logistic regression revealed that the risk factors of ALD among the participants were aged >40 years, with the education of junior high school or above, living in rural area, smoking, and alcohol drinking on an empty stomach; while the protective factor was being female.Conclusion The prevalence rate of ALD among native Tibetan adults in Lhasa city was higher than that among residents of other provinces and age, education, living area, smoking, and alcohol drinking on an empty stomach are main risk factors of the disease.