Background: To analyze the current situation and influencing factors of bone mass abnormalities in postmenopausal women in Tibet, in order to provide reference for the prevention and treatment of abnormal bone mass in local postmenopausal women. Methods: A total of 229 Tibetan postmenopausal women were randomly selected from six counties by multi-stage stratified random sampling method. Multiple Logistic regression were used to analyze the status and influencing factors of bone mass abnormalities in Tibetan postmenopausal women. Results: Among 229 postmenopausal Tibetan women, 81(35.4%) had normal bone mineral density, 126 (55.0%) had osteopenia, and 22(9.6%) had osteoporosis. Altitude is the influencing factor for osteopenia and osteoporosis, creatinine and hypertensive heart disease are the influencing factors for osteoporosis. Conclusion: Tibetan postmenopausal women have higher rates of bone mass abnormalities in Tibet, but lower prevalence of osteoporosis. High altitude is a protective factor for osteopenia and osteoporosis, while low creatinine and hypertensive heart disease are risk factors for osteoporosis. We suggest that relevant departments should take targeted measures to reduce the prevalence of bone mass abnormalities in Tibetan postmenopausal women and improve their quality of life.