Earth tubes are earth-to-air heat exchangers that are frequently utilized in energy conscious low-rise buildings, but are scarcely reported for tall buildings. The feasibility of applying earth tube cooling to tall buildings in a hot summer and cold winter climate zone was studied in this paper. Firstly, the designed cooling load of a tall building was obtained from the energy simulation using the baseline and the modified models with applicable energy efficiency measures. Based on the load, the required cooling capacity, the overall section area and the effective length of the earth tube system was deduced from the heat transfer and fluid flow calculation analytically. Then the performance of the earth tube system was crosschecked and verified via the Computational Fluid Dynamics (CFD) simulation. In the CFD simulation, earth tubes with different diameters and lengths, as well as a full-scale earth tube model with surrounding soil above the depth of constant temperature, were investigated. The outlet air temperatures of the full-scale models were computed with the consideration of different axial distances between adjacent tubes. Meanwhile, multiple conceptual design schemes and the tunnel construction method for the earth tube system were proposed from the perspective of performance enhancement, constructability, efficiency and economy. It revealed that earth tube systems are conditionally feasible for some tall buildings if their design guidelines for climate, underground spaces, construction method, friction of tube interior surface, optimization of effective length and axial distance, as well as synergy with other energy efficiency measures are followed. Even the cooling capacity of earth tubes degrade with time due to the accumulated heat underground, but in a hot summer and cold winter climate zone it can still possibly produce cooled air for a tall building with a Floor Area Ratio of less than 7 effectively in summer.