Taking the typical rail corrugation disease as the research object, a three-dimensional wheel-rail transient rolling contact finite element model considering the under-rail structure and wheel-rail elastic-plastic contact was constructed. The three-dimensional wear distribution calculation method based on the finite element model was used to study the wheel-rail contact characteristics and rail wear behavior under uniform speed and traction. The difference, as well as the influence of rail corrugation with different disease parameters on wheel-rail contact characteristics and wear under traction. The results show that the longitudinal force of wheel-rail under traction state is more significantly affected by the inherent stiffness irregularity. The influence of corrugation on relative slip is related to the longitudinal force, and it needs to be superimposed on the influence of inherent stiffness irregularity. The superposition effect is related to the wavelength and valley depth of corrugation. In the valley depth limit of corrugation, when the corrugation wavelength is short or the valley depth is large, the longitudinal force will have a vibration mode similar to the corrugation geometry, resulting in the relative slip distribution related to the corrugation geometry. The change of contact pressure further affects the wear depth, so that the wear near the crest increases, the wear near the trough decreases, and the corrugation further develops. Due to the small phase difference between the wear increment phase and the geometric phase of the corrugation, the rail corrugation tends to slow down, and the corrugation slows down faster under larger wavelength and valley depth. The research conclusions are expected to provide a theoretical reference for the rail maintenance strategy in high-speed wheel-rail corrugation section.