Because they are in enclosed underground buildings, the generator layers of hydropower stations have limited ventilation. In order to reduce the influence of a hot and humid environment on equipment and staff health and create a good thermal environment with good air quality for underground buildings, in this paper, vertical wall-attached ventilation was combined with the generator layer of a hydropower station to replace traditional ventilation. The influence of air supply velocity, air supply outlet position, and the opening mode of the generator layer on indoor velocity and temperature field distribution were analyzed via numerical simulation, and the evaluation indices of different cases were also compared. In the single-sided vertical wall-attached ventilation mode, when the velocity was increased from 4 m/s to 8 m/s, the maximum increment in the energy utilization coefficient was 41%, and the maximum reduction in the velocity non-uniformity coefficient was 9.5%. The results show that the single-sided mode can offer a higher ventilation efficiency than the double-sided mode, with a higher energy efficiency and a more uniform air distribution. Based on the mean temperature and velocity, and the key evaluation indices (head-foot temperature difference, percentage of dissatisfaction, non-uniformity coefficient, energy utilization coefficient, and air diffusion performance index), it is suggested that the single-sided air supply mode should be adopted for this kind of tall building, with an air supply velocity of v = 6 m/s and two open air supply outlets at each interval.