Objective To investigate the service status and training needs of primary care physicians in some areas of Tibet, with the aim of improving the level of local primary medical services. Methods By stratified random sampling, the primary care physicians in Shigatse, Nyingchi and Ngari districts of Tibet were surveyed from March to June 2023. Descriptive statistical analysis was employed to evaluate the demographic characteristics, service implementation and training needs of primary care physicians. Results In terms of service status, hypertension, acute infection and joint pain were the most common diseases. In terms of basic medical services,blood pressure and respiratory rate measurement,wound dressing change and home visits were the main tasks; public health services mainly included health education, hypertension management, and vaccination. The analysis of training needs showed that primary care physicians had a strong demand for training in practical skills, emerging technologies, and first-aid knowledge, and preferred offline training modes, sush as real-operation demonstrations, and face-to-face teaching. In addition, in terms of pre-hospital first-aid and infectious disease knowledge training, the top three first-aid training demands were cardiopulmonary resuscitation,trauma management and acute altitude sickness treatment. In terms of infectious disease training, the primary areas of need included the prevention and control of tuberculosis, hepatitis, and echinococcosis. Conclusions Primary care physicians in Tibet have urgent training needs in practical skills, medical knowledge and first-aid skills, and face-to-face training and on-site operation demonstration have the most favorable effects. In particular, it is necessary to strengthen training in cardiopulmonary resuscitation, trauma management and prevention and treatment of infectious diseases, thereby strengthening the theoretical and practical abilities of primary care physicians and improving the level of primary healthcare.