The invention discloses a method for controlling medium-thick plate Q345 steel flaw detection defects. The method comprises the steps that the component weight ratio of Q345 steel is optimized, the method is applicable to the steel Q345B/C/D, the thickness H is smaller than or equal to 30 mm, and the steel is prepared from, by weight, 0.16 of C, 0.30 of Si, 1.15 of Mn, 0-0.018 of P, 0-0.008 of S, 0.025 of Al, 0.015 of Ti and 0.0020 of Ca; the [MnS] impurities in steel are controlled, the technological process comprises molten iron desulphurization, 120t revolving furnace, LF-slab continuous casting-heating furnace, medium plate rolling and ACC-collection, wherein the sulphur content [S] in molten iron is reduced to be smaller than 0.002% through molten iron desulphurization pretreatment, and the revolving furnace tapping [N] content is smaller than 0.002%; 2, the molten steel temperature and component accuracy are improved through the revolving furnace, and the revolving furnace tapping temperature is larger than 1620 DEG C; 3, LF slagging and desulfurization are carried out to remove impurities, AL-Ca refining agent is added in LF refining, 200 kg of AL-Ca refining agent is added after revolving furnace tapping, the LF refining final slag Al2O3 content is larger than 30%, the power supply time is controlled to be within 15 min, and the molten steel nitrogen content is smaller than 0.0040%; and 4, continuous protection casting is carried out, and the tundish molten steel temperature is controlled to be 1535-1515 DEG C during continuous casting.