Knowledge on the ecology of streams at extreme altitudes is relatively sparse. We conducted a preliminary survey of the macroinvertebrate fauna of Tibetan streams in June 2009 and August 2011 and compared streams with different water sources. We collected quantitative samples of macroinvertebrates and measured physicochemical variables at 16 sites (8 each sampling year) at altitudes ranging from 4315 to 5065 m a.s.l. and grouped the sites into 3 types according to origin: glacier-fed, rain-fed, and lake-outlets. We identified 38 taxa, with a mean of 8.9 taxa per site. Overall the benthic fauna was dominated by insects (71%), mainly Diptera (especially Chironomidae). Ephemeroptera, Plecoptera, and Trichoptera were found at nearly all sites but mostly in low numbers; however, the fauna was significantly different in the 2 sampling years, especially due to the proportions of Chironomidae (68% in June 2009 and 10% in August 2011) and Baetidae (6% vs. 35%, respectively). The 3 stream types had significantly different faunas. Rain-fed streams had the highest total taxon richness (γ-diversity), but glacier-fed streams had a slightly higher taxon turnover rate (β-diversity). Percent glacial cover in the catchment and water turbidity explained most of the variability in taxon richness. Although not particularly taxon rich compared to other high-altitude streams, the Tibetan stream fauna showed considerable spatial variability. The fast retreat of the glaciers and permanent snow fields in Tibet makes further studies on distribution patterns and driving forces for aquatic biodiversity urgent.