To investigate the effect of dimensional changes on the mechanical properties of cemented tailings backfill (CTB), uniaxial compression tests are performed on square CTBs of four different sizes. Combining digital image correlation (DIC) and acoustic emission (AE) methods, the fracture process and AE behavior characteristics of backfills with different sizes are analyzed. The results show that as the backfill size increases, its uniaxial compressive strength decreases, and its strength stabilizes gradually when it measures 100 mm. Under uniaxial compression loading, surface cracks on the smaller specimens evolve rapidly and aggressively, with no significant shedding area, whereas the larger specimens show plastic failure. The cracks expand and penetrate gradually, forming a large shedding area. As the specimen size increases, the backwards trend of the peak value of the ringing count relative to the peak value of the stress becomes increasingly evident. Combining the change law between the r value and the average frequency centroid, the sudden drop point of r value and the lowest value of average frequency centroid can be regarded as the precursor of macroscopic damage.