In this study, three pitaya varieties, Spineless Yellow Dragon, Fuguihong, and Jindu No. 1, were selected as rootstocks. Through systematic observation and analysis of key indicators such as the growth potential of cuttings, grafting survival rate, fruit traits and quality, the most suitable rootstock variety was determined. Combined with the environmental conditions in Hainan, corresponding cultivation and management suggestions were put forward, aiming to provide solid technical support for the development of the pitahaya industry. Rootstock Fuguihong performed the best in the comprehensive survival rate of cuttings and grafting. The promoting effect of growth potential on pitahaya was significantly better than that of other rootstocks. Therefore, Fuguihong was determined as the optimal rootstock. Meanwhile, different rootstocks had a significant impact on the fruit traits of pitahaya (including 10 traits such as single fruit weight, peel weight, pulp weight, soluble solids, and total sugar). During the cultivation and management process, the suitable cultivation conditions for pitahaya in Hainan were summarized. Before cultivation, the field should be prepared and ridged first. 17 tons/667 m² of decomposed sheep manure and earthworm manure in a ratio of 3∶1 were spread over the whole garden. After rotary tillage and deep plowing, ridges with a width of 1m, a height of 25–30 cm, a row spacing of 2 m, and a ditch depth of 30 cm were built. Appropriate branches were selected as rootstocks. After treatment, they were planted at a density of 7 plants per meter in early September. In the first and second ten days of October, the “two-bud side flat grafting method” was used for grafting, and paper bags were put on. At the same time, a “丰” -shaped scaffold was built. Field management included soil covering or planting white clover and laying ground cloth, adjusting water and fertilizer according to the growth status, bending branches and leaving buds when the main branches exceeded the scaffold by 1 m, and closely monitoring common diseases such as sooty mold to ensure the orderly progress of all work, thus promoting the growth and development of pitahaya. This study would lay an important technical foundation for the vigorous development of the pitahaya industry in Hainan, effectively promote the progress of the domestic pitahaya cultivation industry, and significantly enhance its market competitiveness.