The past two decades have witnessed a renewed vigor in research on geological history of the Tibetan Plateau and the newly emerged paleontological evidence has added a crucial, biological dimension to the scientific quest. Here we review an important part of that paleontological evidence, from fossil fishes, and its implications for interpreting evolutionary history of the plateau. We also provide our thought on the future research directions toward a more holistic approach to the understanding of uplift history of the Tibetan Plateau. The rapid uplift of the Tibetan Plateau, caused by the India-Asia plate collusion, during the late Cenozoic has profoundly influenced the geological, biological, and climatic changes in the region, and changed it into a habitat island isolated from the less elevated surrounding environments. As the fishes, along with their habitats, have been rapidly uplifted, they have kept and accumulated the genetic and morphological traits adaptive to the new environment, evolving into new species. To emulate Charles Darwins descent with modification, we have coined ascent with modification to describe this evolutionary pattern of Tibetan fishes. Thus, this makes the Tibetan Plateau a giant laboratory, much like the Galapagos Islands to Darwin, for studying biological evolution in action. Moreover, freshwater fishes are usually restricted to the drainages (and their fossils are commonly preserved in situ), which are in turn constrained by tectonic events, and hence they are ideal candidates in studying biological, geological, and climatic interplays in the ecosystem. The studies of fossil fishes can also reveal many paleoenvironmental proxies such as ancient climate, past drainage patterns, and paleoelevations, helping understand the uplift history of the Tibetan Plateau. In recent years, we have discovered and collected abundant and well-preserved fossil fishes from the Cenozoic strata on the Tibetan Plateau, including Hsianwenia wui, which is an extraordinary thick-boned fish that provides evidence for an extremely high concentration of calcium in the water in which it lived. This linked Hsianwenia wui to the aridification of the Qaidam Basin. On the basis of careful identifications of the fossil fishes with comparatively reliable time scales and present altitudes where they occur, we can estimate the approximate paleoaltitude of a particular area in a particular geological interval, and consequently we can further postulate the time and scale of tectonic events that caused the elevation. Our studies show that some of our fossil sites at high altitude today were still very low respectively during Oligocene, Miocene, and Pliocene whereas several fossil sites were nearly as high during the Pliocene as they are today. Our estimate also shows that since the late Pliocene, the eastern Kunlun has been uplifted no more than 1000 m, which is radically different from some recent paleoaltimetry studies, based on isotopic analyses, that claim a rather disparate range of uplift, i.e., 27001600 m, during the same interval. Conventional wisdom holds that paleontological evidence seems to be less ambiguous and more credible, at least before the further refinement of current paleoaltimetrical techniques.