The cam-linkage mechanism is a typical transmission mechanism in mechanical science and is widely used in various automated production equipment. However, conventional modeling methods mainly focus on the design and dimensional synthesis of the cam-linkage mechanism in the slow-speed scenario. The influence of component dimensions is not taken into consideration. As a result, the model accuracy dramatically falls when analyzing large-size cam-linkage mechanisms, especially in high-speed environments. The kinematic aspects of cam design have been investigated, but there are few studies discussing the motion characteristic and accuracy analysis models of the large-size cam-linkage mechanism under high-speed scenarios. To handle such issues, this paper proposes a parameter optimization methodology for the design analysis of the large-size high-speed cam-linkage mechanism considering kinematic performance. Firstly, the mathematical model of the cam five-bar mechanism is presented. The cam curve and motion parameters are solved forward with linkage length and output speed. Then, a particle swarm-based multi-objective optimization method is developed to find the optimal structure parameters and output speed curve to minimize cam pressure angle and roller acceleration and maximize linkage mechanism drive angle. A Monte Carlo-based framework is put forward for the reliability and sensitivity analysis of kinematic accuracy. Finally, a transverse device of a sanitary product production line is provided to demonstrate the applicability of the proposed method. With the parameter optimization, the productivity of the transverse device is doubled, from 600 pieces per minute (PPM) to 1200 PPM.