Long regarded as a subspecies of the white-cheeked nuthatch (Sitta leucopsis), it nevertheless differs significantly in morphology and vocalizations.

Both S. przewalskii and S. leucopsis have been regarded as closely related to the North American white-breasted nuthatch (Sitta carolinensis).

The cheeks and throat are a white buff-orange, turning to a rich cinnamon on the underparts that intensifies in color on the sides of the breast.

The bird is endemic to areas in southeastern Tibet and west central China, including eastern Qinghai, Gansu and Sichuan, inhabiting coniferous montane forest of spruce or fir.

It was given the rank of full species (separate from the white-cheeked nuthatch) in 2005 in Pamela C. Rasmussen's Birds of South Asia.

[9] Sitta przewalskii was first scientifically described in 1891 by Russians Mikhail Mikhailovich Berezovsky and Valentin Bianchi[10] based on a single specimen obtained in the Haidong Prefecture, in Eastern Qinghai.

[11] The common name and Latin binomial commemorate the Russian explorer Nikolay Przhevalsky,[12] who found the species in Tibet in 1884 and dubbed it Sitta eckloni without providing adequate description, rendering it a nomen nudum.

In turn, it has been proposed that the triumvirate of S. przewalskii, S. leucopsis and S. carolinensis could be related to the Sitta canadensis, monophyletic group, corresponding to the subgenus Micrositta, which includes six species of average-sized nuthatches.[fn.

[5] In 2014, Eric Pasquet, et al. published a phylogeny based on examination of nuclear and mitochondrial DNA of 21 nuthatch species.

[16] Though both species lack the black eyestripe typical of other nuthatches, their coloring is distinct, with S. leucopsis being white- or creamy-buff on its throat, cheeks, breast, flanks and belly, where S. przewalskii has varying shades and concentrations of cinnamon.

[17] The area above the eyes, including the forehead, crown and nape, is a deep blue-black, through the top edge of the mantle.

[4] The face and surrounding areas, including the lores, supercilium, ear-coverts, cheeks and throat are a white buff-orange.

[16] Juveniles of the species resemble adults but for the base of their beaks being yellow, proportionately shorter, and their overall coloring being less vibrant.

"[4] In 1950, English naturalist Frank Ludlow reported a description of the bird, as provided to him by Ernst Schäfer who studied an adult male near Litang in 1934.

It was characterized as: "one of the shyest and rarest denizens of the conifer forest",[29] and one leading a solitary life, much like nearby populations of three-toed woodpeckers (Picoides tridactylus funebris).

[29] The specimen was captured on the outskirts of a forest, on a ridge between two valleys, where it stood on a dead branch from which it launched in pursuit of insects in flight, like a flycatcher.

Despite being described as rare in China and Southeast Tibet,[30] because the taxon is treated instead as a subspecies of S. leucopsis, the evaluation of its population incorporates the relative abundance of its parent species.[fn.