Abstract: Against the backdrop of the global energy system transitioning toward green and low-carbon development, hydrogen energy, as a high-efficiency and low-carbon secondary energy source, a flexible energy carrier, and a clean industrial feedstock, has become one of the key pathways for achieving carbon neutrality goal. China’s resource endowment of being “rich in coal, poor in oil, and lean in natural gas”, together with the fundamental principle of “establishing the new before abolishing the old” in the energy transition, determines that the coupled development of coal and hydrogen is an inevitable choice for balancing energy security and deep decarbonization. In this paper, three practical models for coal-hydrogen coupling are systematically reviewed as follow: coal enterprises shifting from traditional fuel supply to large-scale hydrogen supply; embedding green hydrogen into coal chemical processes to reduce the full-life-cycle carbon footprint; leveraging industrial foundations to build regional integrated hydrogen ecosystems. The progress and bottlenecks of four key technological pathways are analyzed in depth, including coal chemical industry coupled with green hydrogen, hydrogen-based metallurgy, ammonia co-firing in coal-fired power plants, and hydrogen-based carbon fixation. The study points out that the current coupled development still faces multiple practical constraints, including mismatches between the intermittency of green electricity and green hydrogen supply and the stability required for continuous industrial production, incomplete policy systems and market-based pricing mechanisms, high green premiums causing significant economic pressure on enterprises for transition, and difficulty in breaking path dependence and restructuring organizational capabilities in asset-heavy industries. Looking ahead, coal-hydrogen coupling will advance along two directions, extending the supply chain and upgrading the industrial chain, thereby promoting the transformation of the coal industry from a high-carbon fuel to a low-carbon feedstock and energy carrier, providing vital support for China’s energy structure transition and carbon neutrality goals.