Objective. The purpose of this study was to establish the prevalence rate of convulsive epilepsy and the treatment gap in some rural areas of Tibet Autonomous Region in China, to evaluate the quality of life (QOL) of patients with epilepsy and identify factors contributing to their QOL. Methods. A door-to-door epidemiological survey using randomized cluster sampling was conducted in a rural population in Tibet. A screening questionnaire for convulsive epilepsy was used. Clinical and sociodemographic data were collected from patients confirmed as having convulsive epilepsy. QOL was measured with the Quality of Life in Epilepsy inventory (QOLIE-31). Factors associated with QOLIE-31 total and subcomponent scores were analyzed by multiple regression analysis. Results. A total of 14,822 people were screened. Of these, 37 were confirmed to have convulsive epilepsy, which was active in 35. Lifetime prevalence was estimated to be 2.5 per 1000 in this population. Nearly 60% of patients received traditional Tibetan treatment; 97% of the patients with active epilepsy did not receive reasonable antiepileptic therapy in the week before the survey (treatment gap). The mean QOLIE-31 total score was 42.2 (SD 17.6), with the lowest subcomponent score 22.6 (SD 20.3) for Seizure Worry and the highest 85.8 (SD 18.6) for Medication Effects. High seizure frequency, low economic status, advanced age, late seizure onset, and high education level significantly correlated with low QOLIE-31 total and/or subcomponent scores. Conclusions. The prevalence rate for epilepsy was relatively lower than reported for other rural regions; however, the large treatment gap and poor QOL indicated the pressing needs for medical, financial, and social support in this population. (C) 2007 Elsevier Inc. All rights reserved.