This paper, combined with an example of an old bridge maintenance project, introduces the selection, system composition, and design key points of each component of a clamp-type temporary hoisting system for replacing hangers in a bottom-bearing steel pipe truss concrete arch bridge, and verifies it through theoretical calculation and test conditions using finite element programs. In addition, it focuses on the installation and construction technology of the temporary hoisting system. The engineering practice has proved that the clamp-type temporary hoisting system can safely and effectively achieve the replacement of hangers. At the same time, this practice can provide reference for the design and construction of similar bridge type hanger replacement and similar temporary hoisting systems.