The development of underwater acoustic networks is a significant expansion of Internet-of-Things technology to underwater environments. These networks are essential for a variety of marine applications. For many practical uses, it is more efficient to collect marine data from a remote location over multiple hops, rather than direct point-to-point communications. In this article, we will focus on the underwater acoustic string network (UA-SN) designed for this type of application. We propose a Robust and Adaptive Pipeline Medium Access Control (RAP-MAC) protocol to enhance the network’s transmission efficiency, adaptability, and robustness. The protocol includes a scheduling-based concurrent algorithm, online real-time configuration adjustment function, a rate mode adaptive algorithm, and a fault recovery algorithm. We conducted simulations to compare the new protocol with another representative protocol, validating the RAP-MAC protocol’s adaptability and fault recovery ability. Additionally, we carried out two large-scale sea trials. The results of these experiments indicate that the RAP-MAC protocol ensures effectiveness and reliability in large-scale multihop UA-SNs. In the South China Sea, we were able to achieve a communication distance of 87 km with a throughput of 601.6 bps, exceeding the recognized upper bound of underwater acoustic communication experiment performance by 40 km·kbps.