Abstract: Research on the deformation and failure mechanism of rock slopes in high-altitude cold areas has obtained certain results, but based on the current theory and technology, it is difficult to comprehensively solve problems related to the cold-slope instability mechanisms and disaster prevention and control. As yet, no overall research system for high-altitude slope mining or criteria for slope stability have been established. In this paper, based on an extensive literature review, five measures of the deformation and failure of alpine rock slopes were presented, including the indoor rock mechanics test, simulation of physically similar slopes, multi-field multi-phase coupled numerical simulation, in-situ monitoring of deformation and damage, and the instability mechanism of rock slopes in high-altitude cold areas. After summarizing the research results related to the deformation and failure of alpine rock masses, existing problems were discussed and current research deficiencies were analyzed. The key problems that require urgent solutions in the research of the deformation and failure of alpine rock slopes were summarized. The first problem is the damage mechanism of a rock mass in a high-altitude cold area under mining disturbance conditions. The second problem is the aging characteristics and evaluation methods of the instability of a flow–solid–gas multi-phase multi-field coupled slope under freeze–thaw cycles. The future research direction and development trends in the deformation and failure of rock slopes in cold regions with high altitude were also analyzed. Research should be conducted on the following: (1) the damage degradation mechanism of rock masses with different stress paths coupled with freeze–thaw cycles, (2) the structural plane collapse mechanism and instability of rock slopes in high-altitude cold areas under the condition of blast mining, (3) the dynamic response and disaster occurrence law of jointed rock slopes in high-altitude cold areas under earthquake loading, (4) the mechanism of damage deterioration of jointed rock masses under multi-field and multi-phase coupling conditions, and (5) real-time safety monitoring and early-warning technology regarding the instability of multi-parameter cold resistance of mine slopes in high-altitude cold areas. These five research areas constitute the trends of future research.