The invention discloses a pre-tensioning prestressed structure turnout slab for a ballastless track. The pre-tensioning prestressed structure turnout slab comprises a slab body poured by concrete and a reinforcement cage, wherein all steel bar nodes of the reinforcement cage are insulated, a plurality of sleeves for installing a turnout steel rail are pre-embedded on the slab body, horizontal sleeves of which the center connecting lines are perpendicular to the turnout steel rail are arranged on corresponding track support tables, and the upper end faces of the track support tables are bulged out of the slab body to support a fastener system and a the turnout steel rail. According to the structure of the pre-tensioning prestressed reinforcement adopted by the invention, after the prestressed reinforcement is tensioned, the concreting and the maintaining are carried out to form into the turnout slab, so that the prestressed pre-tensioning turnout slab built by the method is extremely good for controlling the crazing caused by the change of the environment temperature, the durability of the concrete can be improved, and the service life of the turnout slab can be prolonged.