According to 4 aspects, including effect of plateau climate and environment on human health, epidemic characteristics of natural focal disease on Qinghai-Tibet plateau, supplying condition of drinking water resources and managing mode of Qinghai-Tibet railway operation, this paper does research on main facing problems of hygienic support work during Qinghai-Tibet railway operation. It also represents if hygienic support work needs to reach zero death object, it must follow up the overall thinking that people oriented, management centric, equipment as base and environment as condition. It makes design of stratification and structure of hygienic support system, and makes a detailed discussion of mutual dependent relations, status and effect of each factor existed in stratification and structure. It discusses the key technologies and presents suggestions. The key technologies include checkup appraisal mode used for plateau traveling staffs to ensure the hygienic support system go on wheels, the scheme of pressure oxygen supplying and new wind rate exchange for plateau passenger trains, information transport system used for Qinghai-Tibet railway hygienic support, and medical rescue preparatory scheme for accidental accidents [1-3] . According to 4 aspects, including effect of plateau climate and environment on human health, epidemic characteristics of natural focal disease on Qinghai-Tibet plateau, supplying condition of drinking water resources and managing mode of Qinghai-Tibet railway operation, this paper does research on main facing problems of hygienic support work during Qinghai-Tibet railway operation. It also follows that overall thinking that people oriented, management centric, equipment as base and environment as condition. It also represents if hygienic support work needs to reach zero death object. makes design of stratification and structure of hygienic support system, and makes a detailed discussion of mutual dependent relations, status and effect of each factor existed in stratification and structure. It discusses the key technologies and presented suggestions. The key technologies include checkup appraisal mode used for plateau traveling staffs to ensure the hygienic support system go on wheel s, the scheme of pressure oxygen supplying and new wind rate exchange for plateau passenger trains, information transport system used for Qinghai-Tibet railway hygienic support, and medical rescue preparatory scheme for accidental accidents [1-3].