To investigate the influence of coal pillar width on the stress variation of narrow coal pillar (NCP) in the gob-side tunnel in an inclined thick coal seam, theoretical analysis, numerical modeling, and field monitoring are performed to determine the optimal width of the narrow coal pillars in inclined coal seams. The mechanical characteristics of the NCP for varying widths were investigated. Furthermore, vertical and horizontal stress were calculated for various widths of the NCP. The results revealed that with the rise in the width, the vertical stress initially increased dramatically and then stabilized, whereas the mean horizontal stress increased gradually. The mathematical relation between stress and NCP widths was represented by two fitting equations. The evolution process of the plastic zone in the NCP under various widths and the damage form of various widths were obtained; that is, when the width was small, the position of the roadway near the shoulder corner of NCP was inclined to the top of NCP. The field monitoring data revealed that the optimum NCP width was 4 m. This NCP width could stabilize the roadway and improve the loss prevention of the NCP at the gob-side tunnel of similar mines.