diff --git a/python/sglang/srt/disaggregation/decode.py b/python/sglang/srt/disaggregation/decode.py
index 23acf5222..db2ed2ae9 100644
--- a/python/sglang/srt/disaggregation/decode.py
+++ b/python/sglang/srt/disaggregation/decode.py
@@ -35,6 +35,7 @@ from sglang.srt.disaggregation.utils import (
     ReqToMetadataIdxAllocator,
     TransferBackend,
     get_kv_class,
+    kv_to_page_indices,
     poll_and_all_reduce,
 )
 from sglang.srt.mem_cache.base_prefix_cache import BasePrefixCache
@@ -205,7 +206,10 @@ class DecodePreallocQueue:
                 self.req_to_metadata_buffer_idx_allocator.alloc()
             )
             assert decode_req.metadata_buffer_index is not None
-            decode_req.kv_receiver.init(kv_indices, decode_req.metadata_buffer_index)
+            page_indices = kv_to_page_indices(
+                kv_indices, self.token_to_kv_pool_allocator.page_size
+            )
+            decode_req.kv_receiver.init(page_indices, decode_req.metadata_buffer_index)
             preallocated_reqs.append(decode_req)
             indices_to_remove.add(i)
 
@@ -245,10 +249,30 @@ class DecodePreallocQueue:
         assert req_pool_indices is not None
 
         req.req_pool_idx = req_pool_indices[0]
-        kv_loc = self.token_to_kv_pool_allocator.alloc(
-            len(req.origin_input_ids) + max(len(req.output_ids) - 1, 0)
-        )
-
+        if self.token_to_kv_pool_allocator.page_size == 1:
+            kv_loc = self.token_to_kv_pool_allocator.alloc(
+                len(req.origin_input_ids) + max(len(req.output_ids) - 1, 0)
+            )
+        else:
+            num_tokens = len(req.origin_input_ids) + max(len(req.output_ids) - 1, 0)
+            kv_loc = self.token_to_kv_pool_allocator.alloc_extend(
+                prefix_lens=torch.tensor(
+                    [0],
+                    dtype=torch.int64,
+                    device=self.token_to_kv_pool_allocator.device,
+                ),
+                seq_lens=torch.tensor(
+                    [num_tokens],
+                    dtype=torch.int64,
+                    device=self.token_to_kv_pool_allocator.device,
+                ),
+                last_loc=torch.tensor(
+                    [-1],
+                    dtype=torch.int64,
+                    device=self.token_to_kv_pool_allocator.device,
+                ),
+                extend_num_tokens=num_tokens,
+            )
         assert kv_loc is not None
 
         self.req_to_token_pool.write((req.req_pool_idx, slice(0, len(kv_loc))), kv_loc)
diff --git a/python/sglang/srt/disaggregation/prefill.py b/python/sglang/srt/disaggregation/prefill.py
index 692d014bb..9e080926a 100644
--- a/python/sglang/srt/disaggregation/prefill.py
+++ b/python/sglang/srt/disaggregation/prefill.py
@@ -31,6 +31,8 @@ from sglang.srt.disaggregation.utils import (
     ReqToMetadataIdxAllocator,
     TransferBackend,
     get_kv_class,
+    kv_to_page_indices,
+    kv_to_page_num,
     poll_and_all_reduce,
 )
 from sglang.srt.managers.schedule_batch import FINISH_LENGTH, Req, ScheduleBatch
@@ -154,7 +156,8 @@ class PrefillBootstrapQueue:
                 self.req_to_metadata_buffer_idx_allocator.alloc()
             )
             assert req.metadata_buffer_index is not None
-            req.disagg_kv_sender.init(num_kv_indices, req.metadata_buffer_index)
+            num_pages = kv_to_page_num(num_kv_indices, self.token_to_kv_pool.page_size)
+            req.disagg_kv_sender.init(num_pages, req.metadata_buffer_index)
 
             bootstrapped_reqs.append(req)
             indices_to_remove.add(i)
@@ -300,4 +303,7 @@ class SchedulerDisaggregationPrefillMixin:
                 req.metadata_buffer_index, token_id
             )
         is_last = token_id is not None
-        req.disagg_kv_sender.send(kv_indices, slice(start_idx, end_idx), is_last)
+        page_indices = kv_to_page_indices(
+            kv_indices, self.token_to_kv_pool_allocator.page_size
+        )
+        req.disagg_kv_sender.send(page_indices, slice(start_idx, end_idx), is_last)
diff --git a/python/sglang/srt/disaggregation/utils.py b/python/sglang/srt/disaggregation/utils.py
index 54d344416..7b43566f1 100644
--- a/python/sglang/srt/disaggregation/utils.py
+++ b/python/sglang/srt/disaggregation/utils.py
@@ -4,6 +4,7 @@ from collections import deque
 from enum import Enum
 from typing import List
 
+import numpy as np
 import torch
 import torch.distributed as dist
 
@@ -73,3 +74,17 @@ def get_kv_class(transfer_backend: TransferBackend, class_type: KVClassType):
         }
         return class_mapping.get(class_type)
     raise ValueError(f"Unsupported transfer backend: {transfer_backend}")
+
+
+def kv_to_page_indices(kv_indices: np.ndarray, page_size: int):
+    # 1. The page is guaruanteed to be full except the last page.
+    # 2. page index = kv_index // page_size
+    # The return vector is kv_indices[::page_size] // page_size
+    if page_size == 1:  # shortcut
+        return kv_indices
+    return kv_indices[::page_size] // page_size
+
+
+def kv_to_page_num(num_kv_indices: int, page_size: int):
+    # ceil(num_kv_indices / page_size)
+    return (num_kv_indices + page_size - 1) // page_size
diff --git a/python/sglang/srt/mem_cache/memory_pool.py b/python/sglang/srt/mem_cache/memory_pool.py
index b35419578..37882da72 100644
--- a/python/sglang/srt/mem_cache/memory_pool.py
+++ b/python/sglang/srt/mem_cache/memory_pool.py
@@ -286,8 +286,12 @@ class MHATokenToKVPool(KVCache):
             self.get_key_buffer(i).nbytes for i in range(self.layer_num)
         ] + [self.get_value_buffer(i).nbytes for i in range(self.layer_num)]
         kv_item_lens = [
-            self.get_key_buffer(i)[0].nbytes for i in range(self.layer_num)
-        ] + [self.get_value_buffer(i)[0].nbytes for i in range(self.layer_num)]
+            self.get_key_buffer(i)[0].nbytes * self.page_size
+            for i in range(self.layer_num)
+        ] + [
+            self.get_value_buffer(i)[0].nbytes * self.page_size
+            for i in range(self.layer_num)
+        ]
         return kv_data_ptrs, kv_data_lens, kv_item_lens
 
     # Todo: different memory layout