The given paper is devoted to strength and stability analysis of load-bearing structures of a high-rise (54-storey) building with allowance for actual positions of reinforced concrete structural members (columns and walls). Finite element method (FEM) is used for structural analysis. The authors present formulations of problems, governing equations, information about basic three-dimensional finite element models (so-called “design” (ideal) model, the first “actual” model (taking into account the deviations of positions of columns from the project) and the second “actual” model (taking into account the deviations of positions of walls from the project)) of the coupled system “high-rise building - foundation” within ANSYS Mechanical software and their verification, numerical approach to structural analysis and corresponding solvers. Finite element models include mainly 4-node structural shell elements (suitable for analyzing foundation slabs, floor slabs and load-bearing walls) and three-dimensional 2-node beam elements (suitable for analyzing beams and columns), special spring-damper elements and multipoint constraint elements. Detailed finite element mesh on the bottom foundation slab is agreed with the location of piles. The advanced model of Prof. Yu.K. Zaretsky is used for approximation of soil behavior. Construction sequence and various types of nonlinearities are taken into account. The results of modal analysis, static and dynamic analysis with various load combinations (gravity load, facade load, dead (constant) loads, temporary loads, wind load, snow load, crown load etc.) are considered, the results of the regulatory assessment of the strength of structures (obtained with the use of corresponding software in accordance with design codes of the Russian Federation) are under consideration as well. The corresponding displacements, stresses, natural vibration frequencies can be used for research and development of the correct monitoring method of the foundation and load-bearing structures of a high-rise building.