Abstract: With the continuous increase in coal mining depth in China, the deep complex environment (High in-situ stress, High ground temperature, High seepage pressure, Geological structures, Faults, and Mining-induced effects) is resulting in the growing severity of coal-rock dynamic disasters, which restrict safe production and efficient resource recovery. As the most fundamental bearing structure and the core of disaster initiation in mines, the coal-rock combination has become a frontier research topic in rock mechanics regarding its mechanical behavior and failure mechanisms. This paper systematically reviews recent research progress on the mechanical experiments, acoustic emission characteristics, constitutive models, energy evolution, and instability mechanisms of deep coal-rock combinations. Studies indicate that geometric configurations and confining pressure jointly control the strength, deformation, and failure modes of the combination, with increased confining pressure inducing brittle–ductile transition. Acoustic emission monitoring and velocity tomography reveal a progressive failure process of “first rock, later coal” and identify precursors to instability. A nonlinear constitutive model considering loading–unloading paths has been developed based on crack strain evolution. An instability criterion centered on “coal-rock differential energy” has been proposed, clarifying that the uneven distribution of energy is key to the onset of rock burst. Furthermore, the synergistic failure mechanism between coal and rock has been analyzed, indicating that under deep mining conditions, the influence of material properties is enhanced, and the impact propensity of the combination is significantly higher than that of coal alone. Finally, future research on deep coal-rock combinations should focus on multi-field coupling experiments, intelligent damage diagnosis, accurate constitutive modeling, and active prevention and control technologies to support the mitigation of dynamic disasters.