In complex hilly terrain, the wind field around interfered hills is influenced by nearby hills, which affects the wind-induced fatigue damage of the tension suspension-braced transmission structure. Therefore, the effect of occluding hills must be considered in the analysis of wind-induced fatigue. In order to analyze the influence of occluding hills on the wind-induced fatigue damage of the transmission structure in complex hilly terrain, wind tunnel tests on the wind filed characteristics of complex hilly terrain were first conducted. Based on the test results, the variation of the mean velocity correction factor and the fluctuating velocity correction factor of the wind field around interfered hills, with different slopes, heights and interval distances of occluding hills, were studied, and a corresponding distribution model was proposed. Next, a nonlinear finite element model for wind-induced vibration of the tension suspension-braced transmission structure considering the effect of occluding hills was established using the nonlinear finite element method. Then the time domain rain-flow method and the Miner’s linear cumulative damage theory were applied to estimate the wind-induced damage to the structure. Finally, a two-span tension suspension-braced transmission structure was selected as a case study, and considering the effect of occluding hills, the wind-induced fatigue damage was analyzed using the proposed model. The results show that: the fatigue damage in each part increases initially and then decreases as the slope of the occluding hills increases. The heights of occluding hills have little effect on the fatigue damage of each part, with no obvious trend. When the interval distances between occluding hills is between 0 m and 600 m, the fatigue damage in each part gradually decreases as the distance increases. However, when the interval distance is between 600 m and 800 m, the fatigue damage of each part suddenly increases as the distance increases. Under the influence of the same occluding hill, the fatigue damage of the end of the conductor and the supporting-conductor suspension cable is greater than that at the mid-span.