The shield construction in karst formations carries a high risk, with potential issues such as shield machine overturning and significant surface deformation. This paper is based on the shield construction project of the Bixin Road bypass section of the utility tunnel jointly built on Line 16 in Shenzhen. After investigating the developmental characteristics, scale, and filling properties of the karst, are representative karst caves are selected for experimental research. A comprehensive construction process for karst treatment is developed, and measures for handling abnormal grouting reinforcement situations during karst treatment, as well as methods for testing the effectiveness of grouting, are summarized. During the shield tunneling process, dynamic monitoring and analysis of surface deformation and tunneling posture are conducted. The results indicate that the determined karst treatment scheme is reasonable and efficient. The findings of this paper can provide technical references for karst treatment in utility tunnel shield construction.