Underground space development is a crucial approach to addressing traffic congestion in China’s cities, especially through underground construction. However, the traditional pit internal support system, particularly the concrete internal support system, has significant drawbacks. These include high energy consumption and carbon emissions, which are increasingly prominent issues. In this paper, a hollow precast concrete-filled steel tube (H-CFST) internal support system is proposed and a node connection scheme is designed. Through numerical simulation, the load-bearing characteristics of H-CFST with different aspect ratios, hollow ratios, hoop thicknesses, and hoop lengths are investigated, and the optimal design parameters are obtained. Finally, following a field application, monitoring data reveal that the precast H-CFST internal support demonstrates superior load-bearing capacity compared to the concrete internal support, successfully meeting the criteria for replacement of the concrete support.