Freezing and thawing damage is one of the main damage modes of concrete in cold regions, and the process of freezing and thawing is a gradual destruction and evolution process of concrete materials. A hydrothermal damage coupling model of concrete was established based on the concrete damage theory. This model can simulate water phase change and pore water pressure variation in the process of freezing and thawing of concrete, and reflect the actual damage process by the index of cumulative damage. According to the comparison with available experimental data in the literature, the accuracy of this model was verified. Meanwhile, the influence of the center minimum temperature, cooling rate and initial porosity on the freeze-thaw damage of concrete were also investigated. The results show that the cumulative damage of concrete gradually increases with the decrease of the minimum temperature at the center of the specimen, and the increase of the cooling rate and the initial porosity. Although the damage zone gradually develops inward from the perimeter of the specimen, the maximum damage zone and cracks appear inside the specimens near the prismatic corners and expands to the outside when the cooling rate and initial porosity are overly large. This result explains the phenomenon that the corners are the first to fall off after freeze-thaw damage of prismatic specimens.