Internal steam leakage in steam turbines from the high-pressure side to the low-pressure side through clearances causes loss, resulting in reduced efficiency and potentially compromising the safe operation of the turbine. Therefore, a comprehensive understanding of the flow characteristics of leakage through blade tip clearances is crucial to improve the efficiency of steam turbines. In this paper, the last stage blades of the low-pressure cylinder of a certain 600 MW ultra-supercritical steam turbine unit were studied. A wet steam flow model and a turbulence model were established, and the flow characteristics of the last stage under different inlet parameters, outlet parameters, and tip clearance sizes were analyzed. The results showed that an increase in the clearance size affects the inlet and outlet steam angles of the rotor blades, with significant changes occurring near the blade tip. The main flow velocity inside the rotor blade channel fluctuates violently starting from the 70% axial position. The high entropy region is located near the exit flow region of the rotor blade, with its range expanding as the clearance size increases. The entropy change is significant at 60% blade height and above, with more intense changes occurring in the blade tip area. The relative leakage amount and efficiency change uniformly with clearance variation. Generally, for every 0.1% increase in clearance height, the relative leakage amount increases by ∼0.31%–0.42%, and the stage efficiency decreases by 0.34%–0.44%. The results of this study can provide a theoretical basis and guidance for improving the flow efficiency of steam turbines.