Abstract: With the increasing mining depth and intensity of coal resources, the stability problem of small coal pillar working faces has become increasingly prominent. This paper comprehensively analyzes the deformation mechanism of small coal pillar working faces and the corresponding treatment technologies. Regarding the deformation mechanism, the influences of mining stress, surrounding rock properties, and coal pillar size on roadway deformation are discussed in detail. The redistribution of stress due to mining results in stress concentration of the surrounding rock, and the weakness of the surrounding rock and the unreasonable coal pillar size further exacerbate the roadway deformation. As for the treatment technologies, the methods of strengthening support, optimizing coal pillar design, and grouting reinforcement are introduced. To enhance the load−bearing capacity of the roadway, combined support methods like anchor rods and anchor cables are mainly adopted for strengthening support. Through theoretical analysis and numerical simulation, the optimal coal pillar design can determine the reasonable coal pillar size and layout scheme. Grouting reinforcement can improve the physical and mechanical properties of the surrounding rock and boost its stability. Meanwhile, the study also indicates that in practical applications, a variety of treatment technologies should be comprehensively utilized according to specific geological and mining conditions to achieve the best treatment effect. However, there are still some deficiencies in the current research. For example, the prediction accuracy of roadway deformation in small coal pillar working faces under complex geological conditions needs to be enhanced, and the cost−benefit analysis of treatment technologies is not flawless. Future research requires further in−depth exploration to better ensure the safe production and efficient mining of coal mines.