The invention discloses a tailing filling treatment method which comprises the following steps: (1) mixing tailings, a binder and water, and granulating to obtain granular tailings; and (2) mixing the granular tailings, a cementing material and water to obtain filling slurry for filling. According to the method, the granular tailings are obtained by carrying out granulation pretreatment on the tailings, the mass concentration of the filling slurry is improved, the filling disposal amount of the tailings is increased, and large disposal of the tailings based on the filling mode is achieved. Compared with other filling modes, the filling agent has more excellent compressive strength, fluidity and other filling performance, the mortar ratio can be effectively reduced, and the filling cost is reduced.