Post-translational modification (PTM)-based regulation can be mediated not only by the modification of a single residue but also by the interplay of different modifications. Accurate prediction of PTM cross-talk is a highly challenging issue and is in its infant stage. Especially, less attention has been paid to the structural preferences (except intrinsic disorder and spatial proximity) of cross-talk pairs and the characteristics of individual residues involved in cross-talk, which may restrict the improvement of the prediction accuracy. Here we report a structure-based algorithm called PCTpred to improve the PTM cross-talk prediction. The comprehensive residue- and residue pair-based features were designed for paired PTM sites at the sequence and structural levels. Through feature selection, we reserved 23 newly introduced descriptors and 3 traditional descriptors to develop a sequence-based predictor PCTseq and a structure-based predictor PCTstr, both of which were integrated to construct our final prediction model. According to pair- and protein-based evaluations, PCTpred yielded area under the curve values of approximately 0.9 and 0.8, respectively. Even when removing the distance preference of samples or using the input of modeled structures, our prediction performance was maintained or moderately reduced. PCTpred displayed stable and reliable improvements over the state-of-the-art methods based on various evaluations. The source code and data set are freely available at https://github.com/Liulab-HZAU/PCTpred or http://liulab.hzau.edu.cn/PCTpred/.