Abstract: The prestressed high strength concrete pile (PHC pile) is suitable for deep soft clay soil. Using the PHC piles for foundation pile has significant advantages of technical and economic indexes. Because of quality of the PHC piles, geological conditions, design, construction and management problems, some quality problems of foundation piles may be aroused, i.e., rupture and inclination of pile shaft, low bearing capacity, large settlement, bad welding seam of the pile lapping. Based on the geological characteristics and construction of PHC piles, the causes of pile quality accident are analyzed from the results of high strain tests, low strain tests, static loading tests and video monitoring through the holes combined with engineering examples. The preventive and treatment measures are provided.