The invention provides an oil and gas pipeline defect judgment and repair method and device. The method comprises the steps of acquiring the pressure distribution of a pipeline to be evaluated under normal operation conditions along a line, drawing a pipeline mileage-pressure chart; or simulating the pipeline operation conditions through a pipeline simulation system, computing the pressure valuescorresponding to pipeline mileages, and drawing the pipeline mileage-pressure chart; determining a residual strength evaluation model applicable for the pipeline; computing the predicted failure pressure of each defect point; determining the safety factors corresponding to different pipe sections; computing the safe working pressure corresponding to each defect; tracing all defect points accordingto the mileages and safe working pressure corresponding to the detect points in the obtained pipeline mileage-pressure chart; and judging the pipeline defects and repairing the pipeline according tothe chart obtained by tracing the points. According to the method, the pipeline operation conditions are combined fully, and the actual pressure distribution of the pipeline along the line is considered; and the pipeline repair and maintenance decisions can be optimized on the premise of ensuring the pipeline safety operation, and the pipeline operation and maintenance cost is saved.