To monitor changes in building tilt angles more accurately and efficiently and to safeguard the people's safety and property, a new tilt angle monitoring method was proposed in this paper. This method adopts double square artificial marks and a plumb line determined by MATLAB to record changes in the building tilt angle based on image processing technology. Two black square artificial marks with the size of 10 mm × 10 mm were placed near the side of the plumb line. A digital camera was adopted to collect tilt images which were saved in the computer. The tilt images were successively subjected to image greying, binarization, denoising, image segmentation and pixel calibration. Finally, the true length of a single pixel and tilt angle change value would be obtained. The experimental results showed that the accuracy of the method was 96% higher than the manual method. Compared with traditional manual methods and three-dimensional scanning monitoring methods, the advantages of this method are that the equipment used is relatively cheap, the image calculation workload is small and is suitable in dangerous working conditions. In conclusion, the proposed technique could accurately, concisely and effectively calculate the changes in building tilt angle and improve work efficiency.