Under-reamed piles with one or more bulbs have been widely used in almost all types of soil to support a range of structures. In some cases, in addition to vertical compressive or uplift loads, piles must withstand a considerable lateral load. A 3-D finite element study using ABAQUS software was conducted to examine the behavior of under-reamed piles in clay soil under pure lateral, pure uplift, and combined uplift and lateral loads. In this study, pile (L/D) ratios of 11.66, 15, 20, and 25 were considered by adjusting the pile length to simulate the behavior of rigid and flexible piles. The piles were modeled as a linear elastic material, and the soil behavior was simulated using the Drucker-Prager constitutive model. The findings show that the lateral resistance of piles with (L/D) ratios of 11.66 and 15 increased slightly when under-reamed piles were used. However, no change in lateral resistance was observed for under-reamed piles with (L/D) ratios of 20 and 25 compared with straight piles. The uplift capacity of under-reamed piles was significantly greater than that of a straight pile. The lateral capacity was marginally influenced by the prior uplift loading, such that it decreased for a rigid under-reamed pile, and increased for a flexible under-reamed pile.