Cultural exchanges in the Gansu-Qinghai region, especially the Hexi Corridor, surged during the early-to-mid-2nd millennium BCE. Previous studies have often focused on metalwork and the transformation of subsistence economies, whereas stone bead ornaments were seldom discussed. Based on the observations and scanning electron microscopy analysis of tens of carnelian/agate beads from the cemeteries of Huoshaogou and Ganguya in the western Hexi Corridor, we argue that some were imported in the form of finished products and some were locally made. In light of this, we reviewed recent publications and examined carnelian/agate beads and bead making evidence in the Gobi area dated from the 2nd millennium BCE. The preference for beads in the Gansu-Qinghai region began at the turn of the 4th and 3rd millennium BCE. During the 2nd millennium BCE, benefiting from the growth of long-distance exchange networks, some people in the Hexi Corridor were among the first to use ornaments of carnelian/agate, turquoise, fired steatite beads, and seashells. These ornaments later spread to the eastern Gansu-Qinghai region, neighboring the Zhou people. However, the use of carnelian/agate beads remained limited until the Zhou elite incorporated them into their funerary rites. Judging from the similar shapes and crafting features, the carnelian/agate beads in the Gan-Qing region may have had close connections with those circulating in contemporary Mongolia. This study on carnelian/agate beads provides new insights into craft production and society in the Northwest China and north–south exchanges in East Asia.