Abstract: Objective To examine the status of school adaptability among Tibetan high school students in Yushu prefecture during the process of long term mental health reconstruction after experiencing a severe earthquake.Methods Totally 2 000 Tibetan adolescents were recruited from a high school in Yushu prefecture hit by an earthquake on April 4th,2010 and surveyed with the School Adaptability Questionnaire in September 2015.We used t test in data analyses.Results For the 1 976 students giving valid response,the average total school adaptability score was 2.76±0.36 and the total score was significantly different among the students with various characteristics;the highest domain score was 3.36±0.78 for violation of rules,followed by 2.99±0.56 for sense of competition,and the lowest domain score was 2.29±0.72 for intimacy with teachers.Compared to those of the male students,the female students showed significantly higher domain scores for perceived stress from teachers (2.77±0.60 vs.2.68±0.60,t=2.98;P<0.01),breaking rules (3.46±0.80 vs.3.22±0.73,t=6.80;P<0.01),and sense of competition (3.01±0.57 vs.2.95±0.56,t=2.44;P<0.05) but significantly lower domain scores for school attraction (2.34±0.65 vs.2.42±0.66,t=2.79;P<0.05) and intimacy with teachers (2.26±0.71 vs.2.32±0.72,t=2.12;P<0.05).The school adaptability differed by various exposure to the earthquake among the students and the students with higher exposure to the disastrous experience showed lower school adaptability.Conclusion The long-term impact of the earthquake on the mental health of Tibetan adolescents still exists,so it is necessary to pay attention to the reconstruction process of mental health of the adolescents in the disastrous area.