To address the safety disturbance caused by urban rail transit construction to adjacent tall structures, this study conducted a systematic structural safety assessment on a TV tower in the context of construction adjacent to a metro transfer station and a shield tunnel. Field structural inspection, long-term deformation monitoring, and three-dimensional numerical simulation were integrated to assess the current condition of the TV tower structure, the evolution patterns of horizontal and vertical foundation displacements, and the inclination characteristics of the tower body. These methods also accurately quantified the impacts of metro foundation pit excavation and shield tunnel construction on the tower's foundation and superstructure. The results showed that the current concrete strength of the TV tower meets the design requirements, with a historically accumulated foundation inclination ratio of 1.3‰. Numerical simulation predicted that subsequent construction would increase the inclination ratio by 0.31‰, resulting in a total inclination ratio of 1.61‰, which still meets safety requirements. Based on these findings, targeted deformation control standards and engineering recommendations were proposed.