The Kung Co fault in southern Tibet is a major N-S trending normal fault. The associated E-W extension is locally expressed as high-strain ductile deformation. Both field and microstructural observations show that this deformation occurred synchronously with granite intrusion. Previously reported U-Pb zircon dating shows granite crystallization took place at around 19 Ma, implying that ductile E-W extension in the Kung Co area was also active at around 19 Ma. This is the oldest documented example of E-W extension in Tibet and shows that E-W extension was at least locally contemporaneous with N-S extension to the south at shallower crustal levels. Simultaneous mid-crustal N-S extension and upper crustal E-W extension may be explained by southward flow of Tibetan crust with a divergent radial component.