While early modern Europeans traveled by sea to establish new global networks of trade, knowledge, and political dominance, during the same period a proliferation of Tibetan Buddhist monasteries began to link the inner Asian continent more closely overland with China. This study will focus on a developing aspect of these monasteries’ ‘useful knowledge,’ their medical colleges. I will map the network of Tibetan Buddhist medical colleges from an original model in the Dalai Lamas’ capital Lhasa (the Iron Mountain Medical Monastery, founded 1696), through their subsequent appearance across Tibet, Mongolia, and China (patronized with the wealth of the China-based Qing empire during the 18th and 19th centuries), and end by considering a new, self-consciously ‘modern’ institution – incorporating a British-style public health programme run according to Tibetan medical theories and methods – built in Lhasa just after the Qing empire crumbled (the School of Medicine and Astrology, founded 1916). These medical colleges accompanied the spread of Tibetan Buddhism not only to new populations, but also to new segments of populations beyond elites. While the close relationships between medicine and Buddhism, and medicine and Buddhist ‘conversion’ have been previously remarked, they remain little understood. Tibetans were never able to unify politically during this period. Tibetan Buddhism and Tibetan medicine, by contrast, entered a golden age of influence over a range of distinct cultural areas and competed successfully within the diverse and evolving Qing medical marketplace, begging the questions: what did it mean to be a “Tibetan” Buddhist at this time? And what aspects of Tibetan Buddhist knowledge and practice account for its dynamism during this early modern period? By examining changes in the colleges’ organization, constitution of medical knowledge, and practices, I will investigate the nature of their perceived efficacy and appeal, as well as the role they played in extending a shared way of life among Tibetans, Mongolians, Monguors, Manchu and Chinese within the context of regional and imperial relationships.