The plateau environment is characterized by low pressure,low oxygen partial pressure,strong radiation,cold,strong wind,low humidity,and lot of disaster weathers.This drastic climate change is the key factor leading to intestinal mucosal injury.The intestinal mucosal barrier plays an important role in protecting the body from endogenous microorganisms and their toxins.Study on the mechanism of intestinal microecological imbalance under hypoxia is helpful for the diagnosis and treatment of high altitude gastrointestinal diseases.Most studies have shown that plateau hypoxia can lead to overgrowth and ectopic colonization of mucosal flora,destroy the intestinal barrier,and result in increased intestinal permeability,endotoxemia and release of a large number of inflammatory factors.Intestinal motility disorders even leads to the imbalance of intestinal microflora.In this review,we briefly discusses the relationship between plateau hypoxia and intestinal microecological imbalance.