To further improve the design and calculation theory of prestressed anchor-cable piles and save investment, a graded calculation method and subgrade coefficient method are adopted. Based on the deformation theory of cantilever-beam bearing strata and the elastic foundation-beam theory, the pile deformation and internal forces under anchor-pile deformation compatibility are computed, so as to control deformation at the pile anchorage face and optimize pile diameter, anchor prestress and anchor length. According to pile internal-force variation and by the limit-state method, double-face reinforcement is designed for positive/negative bending moments. Engineering practice shows the theory reflects site conditions well.