Karst caves and faults are big challenges in tunnel construction. Water gushing happens in these strata frequently, which affects construction schedule and construction safety. Qiyueshan Tunnel on Yichang-Wanzhou Railway crosses underground rivers, karst caves and fractured faults in high pressure and water gushing strata. Fractured fault F11, which has high water pressure, large volume of water gushing and complicated geological condition, is the key of the whole tunnel. Taking the technologies of grouting, water control and rock collapse prevention adopted for fault F11 as an example, the authors present the new construction scheme, new construction technology and new effect examination method for water control and rock collapse prevention in high pressure and rich water fault F11. This paper can provide reference for similar projects in the future.