In order to deeply study the mechanism of prestressed anchor anti-slide pile, an indoor model experimental device was developed, and a finite difference and particle flow numerical analysis model of slope anchor cable anti-slide pile was established based on the reinforcement project of prestressed anchor cable anti-slide pile in a mountain road slope. Based on the analysis of the force and displacement characteristics of the anti-slide pile, the influence of the prestress of the anchor cable, the inclination angle of the anchor cable, the width and column spacing of the anti-slide pile and the inclination angle of the landslide, the height and nature of the filling soil on the force and deformation characteristics of the pile are discussed, and some design parameters are optimized. Results show that the larger the prestress of the anchor cable, the smaller the displacement of the pile body, but the excessive stress is not conducive to the safety of the pile body. The optimal tension should be 50–70% of the designed tension of the anchor cable. With the increase in the inclination angle of the anchor cable, the displacement of the pile decreases first and then increases, and there is an optimal inclination angle of the anchor cable. In the double row piles, with the increase in pile spacing, the front row piles gradually change from supporting the soil between the double row piles to supporting the sliding body with the back row piles, and the double row piles are plum-shaped. When the pile spacing is 2.5 times the pile diameter, the force of the front and rear piles is the most reasonable. In the process of soil arching evolution, the influence of cohesion on the soil arching effect is greater than that of the internal friction angle.