The invention provides a clay adhesion test device with upward soil pushing and extruding effect and adjustable contact area and test method. The test device comprises a cylindrical soil box, an annular metal backing plate, a soil box cover plate, a fixed pulley block, a water storage bottle, a water supply bottle, a flowmeter, a balance, an air compressor, a water supply barrel, a pressure control valve, a pressure meter, a water bag, a valve, a hose and a nylon rope, wherein constant pressure is set by the air compressor and loaded to the water supply barrel, the water bag swells under the constant hydraulic pressure to produce an upward soil pushing and extruding effect, soil samples are loaded uniformly, and interfacial stress between the soil samples and the soil box cover plate is more uniform. The adhesion of the soil samples with different contact areas with the soil box cover plate is tested by replacing annular metal backing plates with different cross section areas, and by means of the annular metal backing plates, the problems about adhesion test under different contact areas and the soil samples adhering to the bottom surface of a test disc in an adhesion test are solved effectively.