With the development of the city, after a certain number of years of operation and use, the main pipe for urban sewage conveyance is aging and seriously corroded, the uneven settlement of the foundation is aggravated, and the surrounding environment changes, which lead to the damage and destruction of the pipeline. As the core facility of the urban water environment management system, the repair of the main pipe for sewage conveyance under the normal operation has become an urgent technical difficulty to be overcome in the drainage industry. Taking the completed repair projects of the old box culvert in the western section of the south line, the box culvert in the south trunk line reconstruction project, and the trunk line in the Combined Sewage Phase I Repair Project under construction in Shanghai as the examples, the technologies such as temporary drainage design and construction, waterstop repair and stainless steel lining repair applied in the repair of large sewage pipe culvert under different operating conditions are summarized, which provide reference and insights for similar projects.