Previously conducted studies have established that the rationality of the parameters of medium-deep hole blasting is one of the main factors affecting the blasting effect. To solve the problem of the parameter design and optimization design of medium-deep hole blasting in underground mines, a method of parameter design and the optimization of medium-deep hole blasting based on the blasting crater tests and numerical simulation analyses has been proposed in this study. Based on the background of deep underground mining in Gaofeng Mine, a two-hole blasting model has been established, and the blasting parameters are simulated and analyzed by the damage stress variation of the two-hole model. During the study, the initial values of blasting parameters were first obtained from the field blasting crater test, then the blasting parameters were optimized and analyzed by LS-DYNA software, and finally, the optimization scheme was demonstrated by the corresponding blasting test. The results of the field test showed that the design method of integrated blast crater test and numerical simulation analysis can effectively optimize the design of medium-deep hole blasting parameters and improve the blasting effect to a large extent. This study also provides an effective design system for the design of deep hole blasting parameters in similar mines.