The Qinghai-Tibet Plateau is characterized by high altitude, dry climate, large temperature difference, strong radiation and other environmental characteristics, which brings many difficulties and challenges to the preparation and construction quality control of concrete for railway construction on the plateau. To solve the outstanding problems of concrete in the plateau extreme environment, such as poor working performance, easy cracking, shrinkage and creep, lack of corrosion resistance, lack of durability, etc., has become an important issue that attracts much attention and needs to be solved urgently. For a long time, railway engineers and technicians have carried out a lot of scientific research in order to improve and enhance the durability of plateau railway concrete structure and prolong the service life of railway engineering, and obtained rich results, and has been widely used in practical railway engineering. This paper focuses on the comprehensive research, analysis and control of the foreseeable weak points in the aspects of raw material control, mix design, mixing, transportation, pouring and maintenance of plateau railway concrete, in order to provide guidance for the quality control of plateau railway concrete.