Abstract: Coal resources and sandstone-type uranium deposits are widely co-occurring and superimposed in many large sedimentary basins in China. Under the combined disturbances induced by underground coal mining and in-situ leaching of sandstone-type uranium deposits, groundwater systems are exposed to compound contamination risks characterized by high salinity, heavy metal enrichment, elevated radioactivity, strong acidity/alkalinity, and high oxidizing conditions. Based on a systematic review of groundwater pollution prevention and control technologies for coal mines and in-situ leaching uranium mines, this paper focuses on the compound characteristics of groundwater contamination in coal-uranium coexisting mining areas and analyzes the limitations of the current fragmented governance model, in which “coal mines manage coal-related issues and uranium mines manage uranium-related issues.” The study suggests that conventional single-mineral prevention and control systems are unable to fully account for the integrated responses of regional groundwater flow fields, hydrochemical fields, and contaminant plume migration. Such systems may lead to fragmented monitoring networks, isolated data systems, local-scale remediation that is disconnected from regional risk control, and an imbalance between localized treatment and overall environmental risk management. To meet the groundwater environmental safety requirements under coordinated coal-uranium mining conditions, this paper proposes an integrated framework for groundwater pollution prevention, control, and remediation in coal-uranium coexisting mining areas. The proposed framework includes the development of multi-field coupled groundwater simulation software for coordinated coal-uranium mining, the establishment of a shared groundwater monitoring and early-warning system for coal and uranium mines, and the construction of a collaborative digital twin platform. It also involves the coordinated treatment and reinjection of mine water and associated flowback water, the establishment of hydraulic curtain between coal mining and uranium mining areas, and the joint optimization of mining schedules and pumping-injection schemes. Through these measures, aquifer water-level evolution and contaminant plume migration can be regulated at the regional scale, thereby enabling the simultaneous prevention and control of groundwater contamination from both coal and uranium mining activities. This paper further provides a macro-level analysis of the comprehensive benefits of integrated prevention and control, including reducing regional groundwater environmental risks, improving the resource utilization efficiency of mine water, and supporting coordinated coal-uranium exploitation. The findings offer an important conceptual basis for the safe, green, and efficient development of coal and uranium resources.