To study the eccentric compression performance and failure mechanism of ultra-high performance concrete (UHPC) encased concrete-filled steel tubular (CFST) medium-long columns (UC-CFST medium-long columns), a total of 27 UC-CFST column specimens were tested under eccentric compression with eccentricity and slenderness ratio as the main parameters. After verified by experimental results, the finite element (FE) analysis of UC-CFST medium-long columns with actual structural cross-sectional size under eccentric compression was further carried out. It is found that as the slenderness ratio and eccentricity increased, the bending stiffness and the ultimate bearing capacity of the UC-CFST columns decreased gradually, and the failure mode changed from strength failure to instability failure, and the smaller the proportion of encasing UHPC area, the greater the upper-bound slenderness ratio of strength failure. Moreover, the influence of eccentricity was nonlinearly coupled with slenderness ratio on the eccentric compressive bearing capacity of UC-CFST medium-long columns. Finally, a calculation method of ultimate load-bearing capacity of UC-CFST medium-long columns considering the influence of eccentricity and slenderness ratio was proposed, which had good calculation accuracy with experimental and numerical results.