This article investigates some of the socio-economic dimensions of contemporary Tibetan medical practices in the rural areas of the Tibet Autonomous Region (TAR), China. The article is divided into two parts. Part One, printed in the last issue of the journal, deals with traditional medical practitioners and their medical practices within the governmental health care system in the TAR. It sheds light on the workings and the effects that the commodification of the official health care system have had on its Tibetan medical practitioners, most of whom now work as hybrid practitioners and incorporate Chinesestyle biomedicine into their practice. I argue that several historical, social and political factors have brought about unequal access and availability of Tibetan medicine as compared to Chinese style biomedical care in the rural areas. Special attention is given to the role of the reintroduction of the Cooperative Medical Services (CMS) scheme in the sidelining of Tibetan medical practices in the rural areas. Part Two describes the work of private Tibetan medical practitioners and explores some of the social dynamics and ethical dilemmas that have arisen for them due to the commodification of the official system and the reintroduction of the CMS. Both parts focus on the situation in the Tsang or Shigatse region of the western and central TAR, hence enabling there to be useful comparisons with medical practices in the capital Lhasa, where most of the anthropological literature has focused on so far. Both contributions are based on extensive anthropological fieldwork in Lhasa and the Tsang region of Tibet.