As the crosstie beam in railway track systems, the prestressed concrete sleepers (or railroad ties) are principally designed in order to carry wheel loads from the rails to the ground. Their design takes into account static and dynamic loading conditions. It is evident that prestressed concrete has played a significant role as to maintain the high endurance of the sleepers under low to moderate repeated impact loads. In spite of the most common use of the prestressed concrete sleepers in railway tracks, there have always been many demands from rail engineers to improve serviceability and functionality of concrete sleepers. For example, signalling, fibre optic, equipment cables are often damaged either by ballast corners or by tamping machine. There has been a need to re-design concrete sleeper to cater cables internally so that they would not experience detrimental or harsh environments. Accordingly, this study will investigate the design criteria and effects of holes and web openings on structural capacity of concrete sleepers under rail loading. The modified compression field theory for ultimate strength design of concrete sleepers will be highlighted in this study. The outcome of this study will enable the new design and calculation methods for prestressed concrete sleepers with holes and web opening that practically benefits civil, track and structural engineers in railway industry.