The invention relates to a solvent-free organic silicon pressure-sensitive adhesive. The organic silicon pressure-sensitive adhesive comprises the following components in part by mass: 100 parts of polydimethylsiloxane of which the end group is alkenyl; 1 to 300 parts of polydimethylsiloxane of which the end group is hydroxyl; 1 to 50 parts of MQ resin, 1 to 30 parts of polyisobutylene, 20 to 200 parts of diluting agent, 0.1 to 5 parts of crosslinking agent and a platinum catalyst capable of curing the organic silicon pressure-sensitive adhesive. The invention also relates to a preparation method of the organic silicon pressure-sensitive adhesive. The organic silicon pressure-sensitive adhesive has the characteristics of high initial tack, long residual action, proper peeling strength, drug penetration and the like, is nontoxic, environmentally-friendly and reusable, and can be prepared into pressure-sensitive adhesive tapes, medical pressure-sensitive adhesive strips and other functional materials requiring the pressure-sensitive performance.