Abstract: With the rapid development of urban construction, the construction of rail-and-road combined tunnels is getting to be an effective way to realize efficient utilization of underground space. Based on the construction conditions of the Sanyang river-crossing tunnel in Wuhan, this paper proposes a construction scheme for the rail-and-road combined tunnel with six lanes based on a comprehensive comparison and analysis of the influences of urban planning and land use, construction difficulties, and construction organization. It describes the relevant calculations and analyses regarding the cross-section arrangement and tunnel structure, etc. Additionally, it discusses a feasibility study of technical difficulties such as equipment manufacturing, long-distance driving, constructing with a small clearance, and adjacent construction, and ultimately provides guidance for this project and similar ones in the future.