China is the world’s largest coal producer country. However, large-scale coal mining has led to severe environmental pollution issues such as surface subsidence and gangue piling up. The gangue discharging amount has ranked the first in the world and coal mine enterprises are facing enormous discharging reduction pressure. This paper summarizes the research progress of the solid backfilling mining technology and then illustrates the realistic demands and significance of implementing underground coal-waste separation. It also focuses on the technical principles, systems and key equipment of the common underground coal-waste separation methods, such as the selective crushing method, the dense medium shallow groove method, the vibro-assisted jigging method and full-size water separation method and ray identification method. In addition, the selection steps of underground coal-waste separation method, the design process of large section separation chamber and the design principle of separation and backfilling system are proposed, finally, the mining-separating-backfilling + X for coal mining is put forward. By combining the technology of mining-separating-backfilling with other technologies, such as gob-side entry retaining with non-pillar mining, gas extraction, solid waste treatment, water protection mining, mining under buildings, railways and water bodies, the integrated mining methods, mining-separating-backfilling + setting pillars, gas drainage, treatment, protection and prevention methods are formed. It also introduced the ‘mining-separating-backfilling + gas extraction’ technology’s whole idea, system arrangement, separation equipment and practical engineering application effects based on the specific engineering case of pingmei no. 12 coal mine. The results indicate that the integration of underground coal-waste separation and solid backfilling technology could achieve gangue discharging reduction, underground washing and surface subsidence control. It is effective at realizing green mining.