The tension cable-supported power transmission structure (TC-PTS) is a new type of power transmission structure suitable for mountainous terrain, and is sensitive to wind load. In this regard, a nonlinear finite element analysis model of wind-induced vibration is proposed for the TC-PTS, and the wind-induced vibration response of the structure is analyzed. Firstly, the tangent stiffness matrix of the three-dimensional truss element for the supporting suspension cable and transmission line, considering the geometric nonlinearity of structures, is derived through the relationship between the element elastic energy and its displacement. Subsequently, the element mass matrix and damping matrix of the supporting suspension cable and transmission line, as well as the element nodal load vector obtained from wind load equivalence, are given. Then, based on the nonlinear finite element theory, the nonlinear dynamic equation of wind-induced vibration is established for the TC-PTS and solved using the Newmark-β method combined with the Newton–Raphson iterative method. Furthermore, the rain-flow counting method and Miner’s linear fatigue cumulative damage theory were used for wind-induced fatigue damage assessment. Finally, a two-span TC-PTS was selected as an example, and the wind-induced nonlinear vibration and fatigue damage assessment were analyzed through the proposed model. The results show that the proposed model has high computational accuracy and efficiency. The first three order vibration modes of the supporting-conductor part of the two-span TC-PTS were antisymmetric vertical bending, symmetric side bending, and antisymmetric side bending. With the increase in wind speed and wind direction angle, the maximum lateral displacement and tension of the supporting suspension cable and transmission line increased, and their degree of increase showed a nonlinear trend. In terms of the wind-induced fatigue analysis results of TC-PTS, the fatigue damage at the end of the supporting-conductor suspension cable was greater than the fatigue damage at its midpoint. Compared to the fatigue damage at the midpoint of the conductor, the fatigue damage at the end of the conductor was less affected by the wind direction angle, and both were more significantly affected by the wind speed.