The earth-rockfill dam is one of the primary dam types in the selection of high dams to be constructed in Western China, since it is characterized by favorable adaptability of the dam foundation; full utilization of local earth, rock, and building-excavated materials; low construction cost; and low cement consumption. Many major technical issues regarding earth-rockfill dams with a height of over 250 m were studied and solved successfully in the construction of the 261.5 m Nuozhadu earth core rockfill dam. This paper describes research achievements and basic conclusions; systematically summarizes the accumulated experiences from the construction of the Nuozhadu Dam and other high earth-rockfill dams; and discusses major technical issues, such as deformation control, seepage control, dam slope stability, safety and control of flood discharging, safety and quality control of dam construction, safety assessments, early warning, and other key technical difficulties. This study also provides a reference and technological support for the future construction of 300 m high earth-rockfill dams.