Wind-wave misalignment is a common occurrence for monopile offshore wind turbines during extreme typhoon conditions. This phenomenon has a significant impact on the structural dynamic response of turbine structures and poses a threat to their structural integrity. In this study, finite element analysis is conducted on 75 sets of working conditions of monopile offshore wind turbines to investigate their dynamic response under different wind turbine operating states, wind-wave misalignment angles, and randomness of wind and wave load conditions. The results of the analysis indicate that the impact of wind-wave misalignment angles on the dynamic response of the monopile offshore wind turbine varies depending on the operational conditions. Furthermore, the study reveals that there are variations in the dynamic response of the monopile offshore wind turbine under different combinations of wind and wave loads. During the parked state and yaw system fault of the monopile offshore wind turbine, the most adverse working conditions need to consider wind-wave misalignment angles of 0° and 180°. In contrast, the most adverse working conditions for operational states emerge when the wind-wave misalignment angle is 90°. These findings highlight the importance of considering wind-wave misalignment angles and the randomness of wind and wave load conditions when assessing the dynamic response and structural integrity of monopile offshore wind turbines.