With the advancement of oil and gas exploration into “deep and unconventional resources” and continuous breakthroughs in horizontal well multistage fracturing technology, Qinghai Oilfield has achieved significant progress in exploration in the Hero Ridge and Dry Wood Ditch areas in recent years. However, the increasing casing deformation caused by large-scale volume fracturing in horizontal wells has greatly affected on-site construction efficiency and the effectiveness of remedial measures. Research indicates that factors contributing to casing deformation in horizontal wells involve various geological and engineering factors, creating a complex interplay of comprehensive influencing factors without a unified understanding. Analysis of deep horizontal well fracturing data in the Qaidam Basin in 2023, using the Spearman correlation coefficient method, reveals a certain correlation between casing deformation in deep horizontal wells and wellbore curvature and construction scale in the Qaidam Basin. It is preliminarily believed that the intersection of large wellbore curvature and strong-layered heterogeneous reservoirs reduces the casing’s deformation resistance. Defects in cementing quality and the increased variation of wellbore stress due to high engineering parameters in deep horizontal wells further contribute to casing deformation in the vicinity of large wellbore curvature. Based on this, optimization of wellbore trajectory and cementing quality has been implemented, along with preventive measures such as controlled-scale fracturing in sections with high casing deformation risks, achieving certain effectiveness.