Aiming at the control problem of surrounding rock of gob-side entry with small coal pillar in medium-thick coal seam, taking 8226 air roadway of Xutuan Coal Mine as the research object, the causes of surrounding rock deformation of gob-side entry under the existing support scheme are analyzed using theoretical analysis and field measurement. The results show that the main reasons for the large deformation of the surrounding rock in the roadway are the low strength-stress ratio of the coal body, the poor integrity of the coal body, the influence of the mining dynamic pressure, and the unreasonable support from and parameters. Based on this, a pre-stressed bolting and shotcrete support technology combining ' high pre-stressed anchor net cable strong primary support + pre-stressed anchor cable injection + roadway side reinforcement during mining dynamic pressure influence ' is proposed and applied in the field. The engineering application shows that after implementing this technology, the displacement of the two sides of the gob-side roadway is 150 ~ 200 mm, and the roof subsidence is 50 ~ 100 mm. The surrounding rock deformation of the gob-side roadway is effectively controlled, which can provide a reference for the surrounding rock control under similar conditions.