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To address the conflict between pressure relief and support effectiveness caused by large-diameter boreholes in roadway surrounding rock, this paper proposes a method involving variable-diameter boreholes for pressure relief and energy dissipation. With a typical rock burst coal mine as the engineering context, the study establishes a mechanical model for variable-diameter boreholes through theoretical analysis to examine the elastic stress distribution around boreholes within the coal body. Physical similarity simulation tests are conducted to investigate the influence of conventional borehole and variable diameter borehole on the transmission pattern of dynamic load stress waves. Furthermore, numerical simulations are employed to explore the effects of reaming diameter, depth, and spacing on pressure relief, energy dissipation, and attenuation of dynamic stress wave transmission in roadway surrounding rock. The results demonstrate that stress within the coal surrounding the variable-diameter borehole correlates with the borehole radius, lateral pressure coefficient, and distance from the point to the borehole center, the extent of the plastic zone is influenced by borehole diameter, spacing, and depth. Increased diameter, reduced spacing, and greater depth of deep reaming holes exacerbate the transfer of stress concentration from the surrounding rock of the roadway to the deeper regions, facilitating the formation of stress double peak areas. Moreover, the variable diameter position should be within the original stress peak position of the surrounding rock in the roadway, with deep reaming passing through the stress concentration area for optimal results. This study offers guidance on the prevention and control technology for rock bursts in deep coal mining operations.