Critical hydraulic structures are increasingly vulnerable to underwater explosion attacks, with the supporting piles being prime targets for terrorist activities. This study investigates the damage effects and mechanisms of prestressed concrete hollow square (PCHS) piles under non-contact underwater explosions. A series of underwater explosion experiments was conducted on four PCHS piles. The dynamic response of PCHS piles throughout the underwater explosion process was simulated using a coupled fluid-solid numerical model. The mechanisms of dynamic damage to the PCHS piles were elucidated through an integrated analysis of both experimental and numerical results. The research indicates that the damage characteristics of PCHS piles include longitudinal and oblique cracks on the lateral surfaces, transverse cracks on the rear side, and localized fragmentation of concrete. Three primary damage modes have been identified: bending failure(L¯c= 0.59 m/kg1/3), combined bending-shear failure(L¯c= 0.36 m/kg1/3), and punching failure(L¯c= 0.24 m/kg1/3). The local and global responses induced by shock waves are the primary causes of structural damage. Furthermore, as the stand-off distance decreases, the impact of explosive bubbles increases the magnitude of the overall response. A comparative analysis also examined the impact of prestress and axial load on the damage behavior of hollow square piles.