Abstract: Objective  To analyze the reasons of PTB patient health seeking delay and diagnosis delay in order to provide evidence for improving.  Methods  Except Taxkorgan County (a high altitude remote small county), all  43 832 cases of active PTB (of which, 7622 cases could not be evaluated due to lack of interval information between symptoms onset to initial health care seeking, accounting for 17.39%) registered from January 1, 2005 to September 30, 2010 in remaining 11 counties in Kashgar were analyzed for health seeking delay and diagnosis delay. In combination with the face-to-face questionnaire investigation for more than 20 cases of PTB patients who completed treatment in 2010 in each county, patient’s TB cognition and health seeking behaviors were analyzed. Meanwhile, the status of township and village hospitals were investigated.  Results  The average interval from symptom onset to initial health seeking was an average of 106.5 days. The overall health seeking delay was 91.98% (33 305/36 210); 51.43% (18/35) for patients who understood the relevant information before seeking health care, and 98.11% (52/53) for those who did not understand, the difference was statistically significant (χ² = 28.24, P<0.01); The average interval from initial health seeking to TB confirmation was an average of 80.1 days. The overall diagnosis delay was 33.25% (12 102/36 393); In township hospital, the sputum smear detection rate was 13.15% (43/327), 93.58% (306/327) of diagnosis rate; 72.64%(146/201) of X-ray quality passing rate, 76.03% (111/146) of diagnostic accuracy rate; village doctor had no ability in TB diagnosis.  Conclusion  Health seeking delay and diagnosis delay are common in local rural areas. Therefore, to strengthen the publicity of TB control strategies and measures for minority population, improve the diagnostic capacity and consciousness of TB referral is the current pressing problems in Kashgar.