Abstract: Based on an engineering example, the reason of sloping prestressed pipe piles (PPPs) and the treatment method for the sloping PPPs are given. First of all, the sloping condition of each pile should be made clearly, then the damaged position of each pile is found out using low strain dynamic tests, and finally, treatment measures are put forward. For the piles with serious deviation of pile tops and rupture of pile shafts, they must be replaced by bored piles. For the piles with smaller slope of pile tops and soundness of pile shafts, they can be directly used after rectification and righting. For the piles with larger deviation of pile tops and defect of pile shafts, the first step is rectification and righting, and then strengthening the pile shafts by placing reinforcement cage and pouring concrete in the cores of piles. The ultimate bearing capacity of the treated single pile accounts for 60% of the design capacity. For the piles with treatment because of serious shortage of bearing capacity, the bearing capacity should be strengthened by adding bored piles. The measured settlement of buildings is small and uniform, and the maximum settlement is only 13 mm, indicating that the treatment method achieves the desired results, and it can be used for reference.