The invention discloses an OFDR-based expressway roadbed disease monitoring system and method. The system comprises a roadbed settlement optical fiber sensing device, a roadbed horizontal deformationoptical fiber sensing device, a bridge foundation pile deformation optical fiber sensing device, a water level change and precipitation optical fiber sensing device, an OFDR optical fiber data acquisition and transmission system, an on-site road condition monitoring system, a solar power supply and data transmission system, an OFDR optical fiber data processing and analysis system, a wavelet processing and noise reduction system, a monitoring result display system, a cloud platform data management and early warning system and a remote receiving system. According to the invention, OFDR opticalfiber data is collected and transmitted in real time; roadbed settlement difference, horizontal displacement, foundation pile dynamic strain response, precipitation, underground water level and riverwater level information are obtained through the optical fiber data processing system; and the information is displayed in a monitoring result display system in a chart manner, is uploaded to the cloud platform data management and early warning system and then is compared with an early warning value, and a disease treatment scheme is searched in time, so that remote monitoring and timely treatmentare realized.