Prestressed anchor cables have been extensively utilized in slope reinforcement engineering. Combining limit analysis with the strength reduction method (SRM), this article presents a new method to assess the three-dimensional (3D) stability of slopes with prestressed anchor cables. Compared with traditional methods, the factor of safety (F-S) calculation method is modified by considering prestressed anchor cable reinforcement by applying a horn-like shape 3D rotational failure mechanism. To validate the proposed method, comparisons between unreinforced slopes and those reinforced with a row of anchor cables are carried out using optimization algorithms and procedures. The minimum width-to-height (B/H) ratio for which the slope can be analyzed using two-dimensional (2D) analysis under different F-S calculation accuracies is obtained. To evaluate the consequences of the model parameters, parametric analysis is performed, assessing the F-S sensitivity, 3D effects, anchor cable axial force, anchor position, anchor orientation, slope angle, internal friction angle, and cohesion on slope stability. Additionally, slope stabilities under the reinforcement of a row and multiple rows of anchor cables are compared and analyzed. The proposed approach can guide the design and evaluation of slope reinforcement with prestressed anchor cables.