Abstract: Abundant water resources stores in the Qinghai-Tibet Plateau and its vicinity, which has huge hydropower development space. The unique topography, geological conditions, earthquake and climate of the Qinghai-Tibet Plateau decide that the hydropower project construction in this area will face a series of engineering geological challenges. So we have to innovate the exploration research methods, study the giant engineering geological problems in advance, fully understand the complex geological conditions, take a positive, prudent, practical work attitude, adopt appropriate engineering scale, scientific planning, appropriate exploit manner, proper dam type and pivot arrangement and effective risk control and other measures. We can effectively avoid the geological risk and hazard. It is possible to safely develop hydropower resources in the region with extremely complex geological conditions.