This paper is mainly concerned with the existence, multiplicity and uniqueness of positive solutions for the fourth-order boundary value problem {u((4)) = f (t; u; u'; u ''; -u'''), u(0) = u' (1) = u ''(0) = u''' (1) = 0, where f is an element of C ([ 0; 1] x R-+(4); R+)(R+ := [0, infinity)). Based on a priori estimates achieved by utilizing some integral identities and inequalities, we use fi xed point index theory to prove the existence, multiplicity and uniqueness of positive solutions for the above problem. Finally, as a byproduct, our main results are applied to establish the existence, multiplicity and uniqueness of symmetric positive solutions for the fourth order Lidstone problem.