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Aiming at the problem of comprehensive detection technology and treatment measures for tunnels crossing large karst caves, this paper systematically carried out the research on advanced detection of karst geology and treatment measures of karst caves in combination with the Qinlan Tunnel Project of Tianba Expressway in Guangxi. The comprehensive detection method of “karst geological survey + geological radar detection + advanced horizontal drilling + three-dimensional laser scanning + geological sketch” is used for advanced detection. On the basis of ascertaining the spatial location and development scale of karst caves, the scheme of tunnel excavation after advanced reinforcement and support treatment such as advanced small pipe grouting is determined. It has been successfully applied to the construction practice of Qinlan Tunnel crossing ZK89+110 large karst caves, and the treatment measures of “root pile + lining strengthening” are put forward. It effectively avoids the occurrence of disasters caused by karst caves, and has important reference significance for similar projects.