Taking Shekoumao tunnel on ShenmuShuozhou railway as an example, the author presents the types of the major diseases of railway tunnels, including cracks of arches and side walls, offsets between arches and side walls, water leakage of arches and side walls, accumulated water on tunnel bottoms, cracks of tunnel bases and drainage ditches and roadbed settlement. The author also analyzes on the causes for these diseases and proposes corresponding treatment measures. The paper can provide reference for the design and construction of similar projects in the future.