Urban tunnel excavations have caused frequent incidents of surface building damage, attracting the interest of the academic community. However, case studies on surface building damage caused by deep tunnel excavations are lacking. Therefore, it is imperative to study the impact mechanism of deep tunnel construction on surface buildings, develop response modes, and formulate protection measures. This study examines a representative case from a village in the southwest of the Loess Plateau, where tunnel construction at 210 m depth has coincided with excessive deformations, cracks, and other damages in surface buildings. Specifically, this study explored the impact of tunnel construction on surface buildings through on-site investigations, surveying and mapping, mathematical statistics, geophysical exploration, and model analysis. The crack mapping and statistical results showed that the building deformation, cracking, and tunnel excavation exhibited high spatiotemporal consistency. Temporally, the occurrence and development of building cracks were almost synchronous with deep tunnel construction, while crack development lagged slightly. Spatially, the degree of development of building cracks, building settlement, and the displacement vector of building cracks were closely related to tunnel construction. Building cracks mainly developed within three times the diameter of the tunnel on either side of the tunnel axes in the plane. The building type had a significant impact on the response to tunnel construction: unengineered civil structures were more sensitive to tunnel construction than masonry-concrete structures and more prone to severe damage. Geophysical survey results indicated that when the surrounding rock stability was poor, the vibration during deep tunnel excavation damaged the original structure of the rock and soil mass, forming a channel for underground water infiltration and leading to a rapid drop in the groundwater table. The resulting desaturation and uneven consolidation of loess under building loads emerged as a fundamental cause of ground-surface building cracking. To avoid surface building cracking induced by deep tunnel construction, it is necessary to conduct a detailed engineering geological exploration before tunnel construction to identify the engineering geological and hydrogeological conditions, develop reasonable construction excavation and support, and develop an underground water seepage prevention plan. It is also important to conduct long-term safety monitoring of surface buildings.