Core drilling construction in high altitude areas faces multiple challenges such as extreme climate, low oxygen environment, complex geological conditions and difficult logistics support. This paper systematically discusses the key issues in the organization and management of core drilling construction at high altitudes, taking the Dangre Yongcuo working area at an altitude of 5700 meters as an example. Through the summary of practice, we have carried out targeted management exploration from the aspects of personnel health protection, equipment adaptability transformation, construction process optimization, emergency plan formulation and so on. Practice has proved that scientific planning of construction period, strengthening plateau operation training, reasonable selection of equipment and increasing logistics support can significantly improve construction efficiency and safety. The case study verifies the necessity of implementing fine management in high-altitude drilling. These practical experiences can provide valuable reference for geological exploration projects in similar extreme environments.