In order to explore the optimal method to prepare high performance activated carbon precursors from medium temperature coal tar pitch, orthogonal tests are adopted to study the effects of oxygen-blowing time in the pretreatment process as well as carbonization temperature and carbonization time in activation and carbonization processes on the adsorption capacities of activated carbon. Moreover, the effects of additives (coke powder and anionic surfactant) on the adsorption capacities of activated carbon are examined. The results show that the factors affecting the adsorption capacities of pitch-based activated carbon, in order of importance, are carbonization temperature, oxygen-blowing time, carbonization time and additives. The optimal conditions for preparation of activated carbon precursor from medium temperature pitch are: 4h for oxygen-blowing time, 400°C for carbonization temperature, 60 minutes for carbonization time and no additives. The iodine absorption capacity of the prepared activated carbon precursor which is activated for 100 min at 800°C is 1739mg/g.