The invention provides a microbial selenium-rich medical fertilizer for preventing and treating root-knot nematode disease, clubroot and soil insects. The microbial selenium-rich medical fertilizer comprises purpureocillium lilacinum, bacillus subtilis, trichoderma harzianum, total matrine, abamectin, selenium-enriched yeast, sugar alcohol composite boron, calcium fulvate, amino acid, tea seed cake, cane sugar and turf. The microbial selenium-rich medical fertilizer is prepared from the following steps: uniformly mixing the tea seed cakes and the turf added with 50% of water, uniformly mixingthe mixture with the selenium-enriched yeast and the cane sugar added with 10% of water, stacking and carrying out aerobic fermentation to form a mixture A; turning and crushing the mixture A, sequentially adding the sugar alcohol composite boron, the total matrine, amino acid raw powder and the calcium fulvate, and fully and uniformly stirring to form a mixture B; and adding the bacillus subtilis, the purpureocillium lilacinum, the trichoderma harzianum and the abamectin into the mixture B, and fully and uniformly stirring to obtain the selenium-rich medical fertilizer. The microbial selenium-rich medical fertilizer can prevent and treat the root-knot nematode disease, clubroot and soil insects. The selenium-rich microbial insecticide-fertilizer is suitable for preventing and treating theroot-knot nematode disease, clubroot and soil insects.