Aiming at establishing the transient flow characteristics of gas–liquid two-phase flow in high-undulation water pipelines, based on the bubble distribution law measured using physical tests, the bubble distribution law function was input into the hump-pipe fluid domain model, and CFD numerical simulation was carried out for different flow rates and different air contents. The CLSVOF two-phase flow model and the RNG k-ε turbulence model were used to analyze the flow pattern evolution and pressure pulsation propagation in the process of gas–liquid two-phase flow through a hump pipe. The results show that the bubble size has a lognormal distribution, the equivalent diameter is between 3 mm and 10 mm, and the evolution of the flow pattern in the hump pipe is complex and violent. In the horizontal pipe section, there are three main flow patterns: bubble flow, wavy flow and segment plug flow. In the vertical pipe, there are two main flow patterns, slug flow and churning flow, and the flow pattern is affected by the flow rate and the air content rate. When air bubbles or air pockets in the pipeline flow through a certain area, this leads to a steep increase and decrease in the pressure pulsation amplitude in the region, and the pressure fluctuation is extremely frequent. Compared with the water flow rate, the air content is the main factor affecting the relative pressure pulsation amplitude under the condition of a 0.15-air content operating mode, which is generally approximately two to six times that of the 0-air content operating mode. The results of the research should facilitate the prediction of stagnant gas pipeline system bursts and water hammer protection, providing a theoretical basis and calculation parameters.