The prediction method for the coexistence of the rail rolling contact fatigue (RCF) crack initiation and wear growth was applied to analyze the influence of axle load on RCF crack initiation and wear growth. The high rail with a small radius of 800 m and a material of U75V heat treatment was taken as the research object. This study found that as the axle load of the vehicle increased from 23 t to 30 t, the average wear rate of the rail in- creased from 3.813 2 μm/104 to 4.208 3 μm/104 cycles. The average cumulative fatigue rate was from 0.019 5/ 104 cycles to 0.028 8/104 cycles and the initiation life of crack reduced from 3.18×105 cycles to 2.31×105 cycles. For each additional ton in axle load, the average rate of wear increases by 1.48%, the average cumulative fatigue rate increases by 6.81%, and the initiation life of crack decreased by 3.93%.