During the operation of a turbine, the water level drop can cause vibration and damage to the flow components, severely threatening its stability and reliability. Investigating the impact of operational parameters on the internal flow field and flow structures of tidal turbines under low flow conditions is crucial for peak shaving and deployment of tidal power stations. This paper takes a 24[Formula: see text]MW turbine as the research object, using numerical calculations to analyze the effects of tailwater height on the flow characteristics and structural properties of the unit under low flow conditions. It studies the hydraulic impact on the flow component walls under different operating parameters and verifies the reliability of numerical calculations through vibration and stress tests. The results show that the increase in tailwater level affects the turbine’s flow characteristics, forming large-scale, high-intensity vortices in the internal flow field and causing pressure pulsations near the wall surface. Modal analysis reveals that under different tailwater heights, the maximum modal effective mass exists along the axis of the impeller, with modal frequencies higher than the main frequencies of pressure pulsations. The impeller region corresponds to the turbine chamber wall bearing significant stress, which induces strain. The magnitude of stress and the degree of strain are positively correlated with the tailwater height. The research findings provide guidance for tailwater regulation and stable operation of tidal power stations.