Urban utility tunnels (UUTs) have become an important infrastructure for sustainable urban development. However, numerous uncertainties brought by the complex stakeholder groups seriously hinder sustainable operation and maintenance (O&M) of UUT projects, which make it necessary to plan the development of UUT projects in advance. Previous studies mostly identified and analyzed the influencing factors from the partial life cycle perspective and neglected the limitations of exploring the complex whole life cycle factors from one single perspective. This paper comprehensively considered the perspectives of stakeholder roles and the whole UUT project life cycle and proposed a factor identification and analysis framework. In the factor identification section: (a) literature surveys were conducted to identify all influencing factors of stakeholders at each stage; and (b) 21 types of factors were identified through semi-structured interviews. In the factor analysis section: (a) the hierarchical structure of the factors was analyzed by introducing the Decision-Making Trial and Evaluation Laboratory (DEMATEL) approach and Interpretative Structural Model (ISM); (b) the various factors were divided into linkage, dependent, autonomous, and driving factors to clarify their influence degrees; and (c) the core influencing factor was determined based on the above analysis results and the two perspectives. The results indicated that (1) the pricing and charging mechanism is the decisive factor affecting the sustainable O&M of UUTs, the government should focus on establishing a standardized and transparent pricing and charging mechanism; (2) policy support to encourage social capital and user participation should be actively explored; and (3) UUT development must rely on the strong promotion of the government, and the needs of all stakeholders throughout the life cycle should be paid attention to. This study can provide useful insights for guaranteeing the sustainable O&M of UUTs in China and similar regions.