Abstract: Extreme events, including natural disasters, geopolitical conflicts, and cyberattacks, have become major challenges threatening the safe operation of oil and gas utility tunnels in China. To systematically identify core risks, reveal their mechanisms, and construct effective implementation pathways for prevention and control—ultimately enhancing the resilience and reliability of national energy infrastructure under extreme scenarios—targeted research is urgently required. This study combines a comprehensive literature review with an in-depth analysis of typical cases. It systematically reviews major extreme incidents involving oil and gas pipelines both domestically and internationally, covering regions such as North America, the Middle East, Europe, and China. By thoroughly analyzing causation mechanisms, failure modes, emergency responses, and post-disaster recovery mechanisms, this research reveals the operational characteristics and evolutionary laws of various extreme events. The study innovatively identifies and distills five core extreme risk factors affecting the safety of oil and gas pipeline systems: (1) geological disasters, (2) terrorist attacks, (3) local conflicts/wars, (4) electrical fire sources, and (5) cyberattacks (hacking). It systematically elucidates the typical manifestations and hazard mechanisms of each factor. Furthermore, four actionable prevention and control implementation pathways are proposed: strengthening key nodes and active defense, monitoring and proactive early warning for extreme scenarios, emergency response and rapid repair guarantees, and strategic backup and system assurance. By identifying core risk factors of extreme oil and gas events and proposing specific prevention pathways, this study provides systematic theoretical support and technical references for the safety design and operational management of China’s oil and gas utility tunnels under complex risks. The findings offer a crucial decision-making basis for improving the national energy infrastructure security system and formulating targeted protection policies and emergency strategies. Consequently, this work holds significant theoretical value and practical guidance for comprehensively enhancing the disaster resistance and operational reliability of China's oil and gas utility tunnel systems under extreme scenarios.