According to field observation and theoretical analysis, the failure of the 1523103 reserved roadway is mainly affected by the lateral support pressure, rock mass strength, and support mode. With the mining of the 152309 working face, the lateral pressure of coal pillars on both sides of the reserved roadway increases, and since the lithology of the two sides and the floor of the roadway is weak, the reserved roadway experiences spalling and floor heave. Through numerical simulation, the distribution law of surrounding rock stress and the displacement of surrounding rock are obtained after the roof cutting and pressure relief of the reserved roadway with hard roof. According to the cause of surrounding rock failure of a reserved roadway, the combined control technology of roof cutting and pressure relief, grouting anchor cable support, and bolt support is put forward. After cutting the roof and releasing the pressure on the working face, the lateral support pressure of the two sides of the roadway is significantly reduced, the deformation of the two sides of the roadway is small, the maximum shrinkage rate of the section is reduced from 70% to 11%, and the deformation of the surrounding rock of the 1523103 reserved roadway is effectively controlled. The successful control of the surrounding rock in the 1523103 tunnel reduces the number of coal pillars to be installed, improves the coal extraction rate, and is conducive to the sustainable utilization of limited natural resources and the sustainable development of the coal industry.