A power electronic transformer (PET) is applied to the high-speed train for lightweight demand. A 300 kW/5 kHz high-power medium-frequency transformer (HPMFT) using hollow conductors in a power unit of the PET is optimally designed in this paper. The target of the design is to balance the loss, leakage inductance, and weight of the HPMFT. For this purpose, the design parameters of the HPMFT are firstly confirmed according to the system structure and parameters of the PET. Secondly, the design process of HPMFT is developed. Finally, the results of 48 design schemes of core-type and shell-type structures are compared by the comprehensive evaluation standard, which equilibrates the three above objective parameters of the HPMFT. According to the optimal scheme, a prototype is manufactured, whose test results verify the correctness of the optimal design method.