Abstract: Objective To understand the prevalence and distribution of chronic diseases in railway workers in Urumqi and provide evidence for the prevention and control of chronic diseases in this population. Methods A total of 1171 railway workers aged 18 years were selected from Urumqi railway system through multi stage stratified random sampling to conduct a field questionnaire survey. Results The overall prevalence of chronic diseases was 42.02% in the railway workers, the prevalence in males was higher than that in females (48.50% vs. 29.80%), and the prevalence increased with age after 25 years old. The first 6 chronic diseases were dyslipidemia, hypertension, coronary heart disease, diabetes, stroke and cancer with the prevalence of 32.45%, 16.82%, 6.40%, 4.95%, 2.39% and 0.77%, respectively. Conclusion Dyslipidemia and hypertension were the major diseases affecting the health of the railway workers Urumqi. Chronic disease prevention and control should be strengthened in the railway workers at grass roots.