Abstract: Against the background of the global shift toward green and low-carbon energy, hydrogen energy, as an efficient low-carbon secondary energy, flexible energy carrier and clean industrial feedstock, has become a key approach to carbon neutrality. Given China’s energy resource endowment and the low-carbon transition principle of “establish before breaking”, the coupled development of coal and hydrogen is an inevitable choice to balance energy security and low-carbon transition. This paper systematically summarizes three practical models of coal-hydrogen coupling, including transforming coal from fuel to hydrogen source, reducing the carbon footprint of coal chemical industry with green hydrogen, and constructing a regional hydrogen ecosystem. It also reviews the progress and challenges of key technologies such as green hydrogen integration in coal chemical industry, hydrogen-based metallurgy, ammonia co-firing in coal-fired power plants and hydrogen-assisted carbon capture. The study points out that the coupled development is restricted by the mismatch between green hydrogen volatility and continuous industrial production, imperfect policy and market mechanisms, and prominent enterprise transformation risks. In the future, coal-hydrogen coupling will promote the transformation of the coal industry from high-carbon fuel to low-carbon raw material and energy carrier through supply chain extension and industrial upgrading, providing strong support for China’s energy transition and carbon neutrality.