Objective To investigate the current prevalence of cerebral stroke and hypertension in Ganzi Tibetan state, so as to control stroke and hypertension in future. Methods A representative people sample of Kangding, Dege, Ganzi, Litang and Batang county was selected through randomized cluster sampling. Data of demographic characteristics, hypertension and stroke status were collected by face-to-face interview. Results 5 049 people were included, of which 48.6% were male, and 51.4% were female. The prevalence rate of hypertension and stroke were 23.4% and 1 894/100 000 respectively. The population with hypertension had high prevalence of stroke. The prevalence increased along with the age. Conclusions The prevalence of hypertension and stroke is high in Ganzi Tibetan state. The causes may be ascribed to special geography surroundings and life style. It is very important to pay more attention to prevent and control of hypertension and stroke in this area.