The invention discloses a low-loss aluminum tube type OPGW power optical cable and a manufacturing method. The optical cable comprises a cable core, an aluminum tube and an outer layer stranded wire from inside to outside. The cable core comprises a center reinforcing element in the center and multiple stainless steel tubes located around the center in a stranding mode. An optical fiber and optical fiber paste are arranged in the stainless steel tubes. The technology of replacing polybutylene terephthalate (PBT) tubes with precise stainless steel tubes is used in the optical cable, the optical fiber stainless steel tubes are of a layer stranded structure, after the cable is formed, the cable is wrapped with a layer of seamless aluminum tube to serve as an optical fiber metal reinforced protective tube, and one or more layers of aluminum-coated steel or aluminum alloy wires are stranded to serve as the outer layer. The optical cable is good in fatigue resistance, excellent in electro-chemical corrosion resistance and better in short-circuit current and lightning electrical characteristic, influences of short-circuit current on optical fiber transmission properties are small, optical fiber protection is relatively perfect, electro-chemical corrosion resistance is avoided, and the optical fiber is more suitable for circuits with large short-circuit current and extreme corrosive environments.