This preliminary research was conducted to evaluate the alpine stream health by using water quality as an indicator in Khunjerab National park of the Karakoram ranges located in Pak-China boarder Pakistan having altitude of 3660 m. This study investigated the stream health in the context of the presence or absence of sensitive species, their diversity, and their taxa richness. The water and macroinvertebrate samples were collected from 17 different locations from upstream and downstream of the river by using random sampling method. Macroinvertebrate samples were obtained using kick net (500-mu m mesh size) and hand-picking method (NYSDEC). A total of 710 counts including 41 families of macroinvertebrates were recorded comprising of 7 orders including: Ephemeroptera (46%) being the most dominant group, Plecoptera (33%), Trichoptera (5%), Chironomidae (Diptera) (14%), Heteroptera (1%), and Coleoptera (1%). Ephemeroptera, Trichoptera, and Plecoptera (EPT) were found in abundance at the main source, Qarchanai, Dhee, and Tourqeen Nullah, as compared to the other locations of the stream. The most dominant macroinvertebrate was Ephemeroptera whose relative abundance is Pi = 0.49 by using the Shannon index. However, different statistical tools, including principal component analysis (PCA), cluster analysis (CA), ANOVA, and linear regression model, show a strong correlation between water quality and macroinvertebrates. The overall results of the biological indicators showed better ecological health at downstream compared to upstream. This study will provide basic information and understanding about the macroinvertebrates for future researchers, and the data will be helpful for upcoming research programs on alpine streams for the discovery and occurrences of macroinvertebrates and associated fauna.