Confined water inrush caused by fault activation is the main form of water disaster in deep mining. With theoretical analysis and similar simulation tests, the mechanism and evolution law of delayed water inrush caused by fault activation are revealed. At the theoretical level, the expansion and extension of the internal microstructure in the fault zone under the action of the mining stress field and seepage field are the essential causes of fault activation. Overlying strata movement and surrounding rock creep failure are the basic reasons for delayed water inrush caused by fault activation, and delayed time caused by surrounding rock creep failure is much longer than that of overlying strata movement. A similar simulation test was carried out with self-development solid–liquid coupling with similar simulation materials; the results show that delayed water inrush caused by fault activation with mining includes three stages. Micro-activation stage: Water inrush weakness point is formed because of the expansion and extension of the micro-fissure and structure at the bottom of the fault zone. Macro-activation stage: With the change in the stress of the waterproof coal pillar and surrounding rock, the micro-fissures and structures in the stress relief area and tension area of the fault zone expand and extend sharply; meanwhile, water intrudes into the interlayer stratification of the floor in the stress relief area, forming a strong laminar flow phenomenon, and cracks in the floor form and expand; finally, water-conducting channels in the fault zone and floor are formed. Water inrush stage: The waterproof coal pillar and water-resisting layer fail and are destroyed, and the first confined water inrush point is located at the junction of the waterproof coal pillar and gob floor.