Abstract: To address limitations of traditional medium-voltage fire-resistant cables, including insufficient fire resistance, low combustion ratings, and lack of intelligent control, a structural optimization scheme for a novel intelligent medium-voltage fire-resistant cable was proposed. Innovative designs such as saddle-shaped filling, intelligent fiber-optic temperature monitoring system, digital terminals, and ceramicized oxygen barrier layer were integrated. The cable's fire resistance, Class B₁ combustion performance level, and power transmission efficiency were comprehensively improved through integration of saddle-shaped filling, an intelligent fiber-optic temperature monitoring system, digital terminals, and a ceramicized oxygen barrier layer, combined with halogen-free low-smoke flame-retardant sheathing materials and active nitrogen cooling technology using freeze-resistant nylon tubes. Experimental tests confirmed that the optimized cable withstood flames of 950 to 1 000 °C for over 90 min, while real-time temperature monitoring and active fire prevention functions were achieved. The experimental results demonstrated that operational stability under fire conditions was significantly enhanced through material optimization and process innovation. The cable met the application requirements for high-safety scenarios such as buildings, rail transit, and power systems, providing a reliable technical solution for electrical fire prevention and control.