The high-speed airflow generated by ultra-high-speed elevators causes significant aerodynamic force, which seriously reduces the comfort and safety of passengers. First, a multi-parameter general model of ultra-high-speed elevator was established, and the three-dimensional numerical simulation of incompressible flow in the ultra-high-speed elevator was simulated. The correctness of the model and method was verified by experiments and grid-independence analyses. On this basis, the variation in the aerodynamic forces and the pressure in the hoistway was analyzed. Finally, the influence of different hoistway structures and parameters of ventilation holes on the aerodynamic forces and hoistway pressure were analyzed. The results showed that the opening of ventilation holes significantly reduced the aerodynamic forces and hoistway pressure for most of the period of the car’s operation period, but both the aerodynamic forces and hoistway pressure showed a sudden increase–decrease process. The aerodynamic forces and hoistway pressure were highly sensitive to changes in the hoistway blockage ratio, the cross-sectional area of the ventilation hole, and the position of the ventilation hole. When a pair of ventilation holes were opened, those in the middle of the hoistway reduced aerodynamic problems in the hoistway to the greatest extent. The increase in the connection angle between the ventilation hole and the hoistway eliminated the low-speed recirculation zone at the ventilation hole and increased the total volume of exhaust air at the ventilation hole.