Considering the aerodynamic loads arising during the process of two high-speed trains passing each other (hereinafter referred to as TPEO) as well as different track excitations on different railway lines, this study examined the combined effect of TPEO and different track excitations on wheel wear. A vehicle system dynamics model was built using the actual parameters of a high-speed train. The wheel/rail contact problems were analyzed using a combination of semi-Hertzian contact theory and Kalker’s simplified theory. Elkins wear index was used as a criteria for evaluation of wheel wear. The additional excitation arising from the pressure wave during TPEO at a constant speed of 300 km/h was applied to the model. Then the effect of the aerodynamic excitation due to TPEO on wheel wear under four track excitation conditions was investigated for the whole train, different cars, and different axles. The results show that under different track excitations, the train’s wheel wear increased in the case where one TPEO event occurred compared to that in the case of no TPEO event. Under the four track conditions (no track excitation, the track excitations on the Wuhan–Guangzhou high-speed railway, German track excitation spectra, and track excitation on the Beijing–Tianjin intercity railway), the total wheel wear increased by 17.36%, 0.69%, 0.82%, and 1% respectively over the entire trip, and increased by 1600%, 65.77%, 78.62%, and 79.73% at the moment of TPEO. A comparison between different cars shows that under different track excitation conditions, the tail car’s wheel wear was the most affected by TPEO, while the head car’s wheel wear was the least affected. A similar pattern is observed in the variation in transverse displacement of wheels under TPEO between different cars. For each bogie, TPEO under different track excitations had a greater effect on the front-axle wheel wear than on the rear-axle wheel wear.