The pressure regimes of the No. 2 coalbed methane (CBM) reservoir in the Yanchuannan field located in the southeastern Ordos Basin are highly variable and divided into overpressured (pressure gradient >9.80 kPa/m), slightly underpressured (pressure gradient of 8–9.80 kPa/m), and moderately underpressured (pressure gradient of 5–8 kPa/m). The controlling factors for the variable pressure regimes were investigated through the analysis of geological and hydrological characteristics. The pressure regimes are controlled by different mechanisms in different hydrodynamic environments. In the closed hydrodynamic environment characterized by TDS > 10,000 mg/L and NaCl type of groundwater, the pressure regime is dominated by overpressured to slightly underpressured and is controlled by CBM migration. Overpressure was developed by thermogenic CBM generation during the coalification process and is maintained by thermogenic CBM migration from the extended northwestward and deeply buried CBM reservoir during tectonic uplift. The transition from overpressure to slight underpressure and then to moderate underpressure towards the southeast is the result of the progressively weakened migrated thermogenic CBM with increasing migration distance. In the open hydrodynamic environment characterized by TDS < 10,000 mg/L and NaHCO3 type of groundwater, the pressure regime is dominated by slightly to moderately underpressured and is governed by hydrodynamics. Groundwater is fed by meteoric recharge along the structurally upturned basin margin and creates the hydrodynamic framework during tectonic uplift. The transition from moderate to slight underpressure towards the southwest is associated with the minor decrease range in ground elevation from basin margin to basin interior and the gradually weakened runoff intensity of groundwater with increasing distance to meteoric recharge. The idealized models for the pressure regimes are established, which can provide guidance to deep CBM sweet spot identification in CBM fields in the eastern Ordos Basin and elsewhere.