ABSTRACT Objective To investigate ultrasound manifestations and clinical value of ASA combining EV remnant of the Tibet Plateau. Methods Retrospective analysis 12 case’s of Tibetan adults ASA combining EV remnant , Summarize the ultrasonic characteristics. Results All the cases’ ASA were located at fossa ovalis. We classified the ASA cases by Olivares-Reyes A standard. In this study, 4cases belong to type I, 7cases belong to type Ⅱ and 1 cases belong to typeⅤ. The height and the base diameter of the ASA were (2.10±1.7) cm and (3.90±3.3)cm, The average thickness was (0.28±0.03) cm .EV originating from the anterior rim of the IVC orifice. The average length and thickness were (4.40±2.7) cm and (0.29±0.07)cm. Conclusions ASA and EV remnant have a high incidence due to environmental factors affect of Tibet plateau, The ultrasonography provides an accurate diagnosis of the ASA combining EV, which can be used as the preferred examination. With their large reference value for clinical diagnosis, ultrasonic inspection results shall be in report.