The reciprocating compressors in underground gas storage (UGS) run under high temperature and high pressure for a long time, which leads to the piston rod bearing complex alternating load, easy to generate fatigue cracks and spread, and eventually lead to fracture failure, which seriously affects the safe operation of UGS. In this paper, the causes of piston rod fracture failure under actual operating conditions are studied by numerical simulation and test. Firstly, a finite element model is established based on the actual cyclic load of the piston rod, which is used as the boundary condition for crack propagation analysis. The crack propagation model is established by adaptive meshing method, and the stress intensity factor leading to crack propagation is determined by M−integral method. According to the fracture toughness of the piston rod material, the fracture failure occurs when the crack propagation length is 29.599 mm, and the fatigue crack propagation life extends with the decrease of the speed or the increase of the exhaust pressure. Secondly, the fracture morphology of the piston rod is analyzed, and the fracture type is determined to be fatigue fracture, and the crack source starts at the transition corner of the surface, which confirms the accuracy of the numerical simulation results. Long-term alternating load leads to stress concentration and initial crack. Metallographic analysis shows that excessive inclusion, abnormal organization and the presence of Se element are the main factors leading to fatigue fracture of the piston rod. The research results provide valuable insights and theoretical basis for fatigue failure problem and fatigue optimization design of piston rod, and have practical engineering guidance significance.