The objectives of this research were to get the information about current status of tilapia culture, tilapia diseases, the problems relating to climate change and other factors affecting the tilapia production. This research had been carried out by farm visits to collect the tilapia culture data such as the cost-benefit, survival rate, the production per area, fish price. The data was then analyzed to generate the sustainable tilapia farming. The data was collected from Chiangmai, Lamphun, Phitsanulok, Kamphaeng Phet, Tak, Mae Hong Son. It was found that most fish farmers do not adjust the culture techniques to improve their productivity. Some set up the aeration; however, the application of them is still not correct. Fish farmers have faced fish death during a culture period, but the sick or moribund fish are not diagnosed. Some chemicals and antibiotics have been used to solve this problem. Some stop feeding until the fish death is over. There are no salt application for stress relief and no water exchange plan for fish culture in earthen ponds. Three major fish bacterial pathogens include Flavobacterium columnare, Streptococcus agalactiae, and Aeromonas hydrophila. Fish death usually occurs during season change from late summer to rainy season; March – July. In cases of fish stress, Trichodina may become pathogenic ectoparasite interfering with feeding and respiration of small fish. The massive deaths of cage cultured tilapia due to the abrupt changes in weather and water quality were reported every year. Tilapia farmers' associations have been formally and informally set up in order to get the benefit from seed and commercial feed buying as well as product selling. There are still a room for Good Aquaculture Practices (GAP) including hatchery, nursery, and on-farm culture because most farmers lack of the motivation to improve their farms due to the GAP fish product is not high.