In this study, a new high-efficiency and high-precision Z-pin pre-insertion based on a combination cam was developed to solve the problems, such as low efficiency, easy breaking, and slipping of Z-pin insertion. One of the aims is also to promote the application of the Z-pin composite technology in both military and civil fields. First, the functional requirements of the pre-insertion machine were analyzed according to the pre-insertion technology requirements of laminated composite members of the rectangle-type aviation. Second, the mechanism motion scheme of the “shear after implant” combined cam-type program was proposed for the pre-insertion machine. The cam mechanism of the pre-insertion machine was designed using the analytical method, and the theoretical profile curve of the cam mechanism was deduced. Third, the elastic dynamics model, including the clearance cam mechanism, was constructed. Next, the rotational speed of the combined cam was optimized, and its virtual prototype motion simulation was performed. Subsequently, the experimental prototype was designed and manufactured, and the correctness and rationality of the combined cam design were verified by conducting the implant experiment. The implant motion scheme was optimized according to the problems found in the experiment. The experimental results showed that the scheme could greatly improve the efficiency of the Z-pin implantation. Its efficiency reached 5 080 mm2/min, the implantation success rate was controlled above 99%, and the implant parameters such as the implant spacing, implantation depth, and fiber length were controlled within ±0.01 mm. Hence, the pre-implanting machine is easy to operate, human-machine interface-friendly, stable in long-term operation, and there are no problems such as Z-pin breaking, which can meet the current requirements of implant efficiency and implantation accuracy of Z-pin implanted devices.