The development of tight reservoirs using a horizontal well requires caution owing to the reservoir sensitivity to stress. Predicting the horizontal wellbore instability during reservoir depletion is critical for tight reservoirs. The present study investigated the wellbore failure criteria and stress orientation changes with reservoir depletion of a horizontal well in a tight reservoir, considering rock sensitivity to stress with pressure reduction. An integrated reservoir model coupled with geomechanics was used to predict pore pressure. A mechanical earth model (MEM) was constructed to examine the stability of horizontal wells. The unconfined compressive strength (UCS) was correlated with changes in porosity due to stress changes. The MEM shows that the failure criteria around the horizontal wellbore, including breakout, loss, and breakdown pressures, change considerably with reservoir depletion. A more significant response was observed in the stress-sensitive layer, which was characterised by a higher permeability. The safe mud weight window of the studied horizontal well narrowed significantly after production for five years, whereas the stability was completely absent after ten years. The deterioration of stability with depletion is governed mainly by permeability reduction, which may cause severe pressure reduction, whereas the stability improvement due to the increase in UCS caused by porosity reduction seems marginal. Relatively small changes in the direction of the stresses around the wellbore with depletion were observed, with the stress distribution concentrated in the predominant direction as the depletion continued. This study indicates that the sensitivity of petrophysical and geomechanical properties to stress amplifies the instability in tight reservoirs, particularly around wellbores.