In order to understand the heat transfer performance, startup and fluid flow condition of oscillating heat pipe (OHP) with hydraulic diameter far exceeding the maximum hydraulic diameter (MHD), an experimental investigation on heat transfer performance and visualization was conducted. From the experimental performance, it is found that the OHP can still work well with ethanol as the working fluid when the tube diameter has exceeded the MHD of 91.6%. In addition, the detailed flow patterns of the OHP were recorded by a highspeed camera for vertical and horizontal orientation to understand its physical mechanism. In the vertical orientation, initially working fluid generates small bubbles, and then the small bubbles coalesce and grow to vapor plugs, the vapor plugs finally pushes the liquid slugs to oscillate in the tube. In the horizontal orientation, the working fluid surface fluctuates due to the vapors flow from the evaporator to the condenser and bubbles burst in the evaporator. When the peak of liquid wave reaches the upper surface of tube, a liquid slug has been formed, and then the steam flow pushes the liquid slugs to oscillate in the tube.