The Sinongduo mining region includes two types of mineralizations: the epithermal and the carbonate-hosted Pb-Zn-Ag deposits. Despite being studied for many years, the ore formation process and genesis of the carbonate-hosted Pb-Zn-Ag deposits remain poorly understood. The Pb-Zn-Ag ore bodies occur as veins and are hosted by limestone and dolostone of the Permian Xiala Formation. Three sulfide mineralization substages have been identified at the Sinongduo carbonate-hosted deposit. Indium coupled with Cu, Co and Sn was incorporated into sphalerite as substitutions: 2Zn2+ ? Cu+ + In3+, (3n/2 + 1)Zn2+ ? Co2+ + nIn3+ or (2n + 1)Zn2+ ? Co2+ + n(Cu+ + In3+) (n > 1) and 4Zn2+ ? Sn2+ + 2In3+. Sphalerite and pyrite in the mineralization stage display δ34S values in a narrow range of +5.7‰ to +11.3‰, which are similar to those of Palaeocene igneous rocks, indicative of a magmatic source of sulfur. We present systematic carbon-hydrogen-oxygen isotope results that further support a magmatic source for the ore-forming fluids that were influenced by meteoric water. Furthermore, the Pb isotope compositions of sulfide minerals in the Sinongduo carbonate-hosted deposit overlap with the values of coeval Linzizong volcanic rocks and are similar to those of Indian Ocean sediments, indicating upper crustal sources of metals. We conclude that the Sinongduo carbonate-hosted Pb-Zn-Ag deposit is a medium- to low-temperature magmatic-hydrothermal deposit related to Linzizong magmatism.