Abstract: The consolidation and improvement of the effectiveness of targeted poverty alleviation in rural areas is a powerful guarantee for the poor people to successfully get rid of poverty during poverty eradication and prevent returning to poverty. Based on the framework of sustainable livelihoods, the article uses field research and descriptive statistical analysis research methods to understand the effectiveness of targeted poverty alleviation in County X of Kashgar, Xinjiang. It also reveals its hidden worries about the sustainability of targeted poverty alleviation. The results of the study show that the effectiveness of targeted poverty alleviation in County X can be evaluated on the reduction in the number of poor people, control of poverty incidence, success of the transfer of characteristic industries and labor, and progress in infrastructure and public service construction. The livelihood environment is fragile, and it is always faced with risks. The structural imbalance between different livelihood capitals has led to a slow increase in its total growth. The lack of effective expansion of livelihood selection space, the coexistence of opportunities and challenges, and other factors have brought hidden concerns about X County’s targeted poverty alleviation. The article focuses on the improvement of the livelihood environment, the optimization of the internal system of livelihood capital, the development of the collective economy, and the further expansion of the livelihood selection space. It puts forward specific countermeasures and suggestions to help the rural poverty alleviation efforts consolidate and improve the results.