The invention discloses a power transmission iron tower high-altitude operation audio-video transmission system. The system comprises a helmet, a safety belt, a ground terminal and a high-altitude operation special interphone, wherein the helmet is provided with a standard-lens camera and a wide-angle lens camera, the safety belt is provided with a wireless audio-video emitter, and the wireless audio-video emitter is provided with an antenna. According to the invention, by use of a portable miniaturized double-image transmission system, i.e., the wide-angle lens camera and the standard-lens camera, wide-angle and high-definition images of work personnel in construction operation, shot by the wide-angle lens camera and the standard-lens camera can be transmitted to a controller in the ground terminal in real time; and the high-altitude operation special interphone can transmit voice signals of the work personnel in the construction operation in real time to the controller in a ground system.