Fourier transform infrared spectroscopy (FTIR) was used to study the molecular structure of four medium- and low-temperature heat-treated medium-rank coals. The FTIR spectral parameters, which consist of CH2/CH3, aromaticity (fa), aromatic carbon rate (fC), aromatic hydrogen rate (fH), oxygen-containing (C-O) rate (IR), organic matter maturity (M), and the degree of aromatic condensation (Dc), indicate different characteristics, including changes in the aromatic hydrocarbon structure, fatty hydrocarbon structure, hydroxyl structure, and oxygen-containing functional groups of medium-rank coal. The results show that with the increase in heat treatment temperature, the sulfur content in coal gradually decreases, but the C/H ratio gradually increases. Meanwhile, the content of kaolinite and pyrite in coal gradually decreases, whereas the content of dolomite and hematite gradually increases. With the increase in heat treatment temperature, the relative content of ether oxygen hydroxyl groups in the hydroxyl structure significantly decreases, but the relative content of self-associated hydroxyl groups increases. The relative content of alkyl ether (C-O) in oxygen-containing functional groups gradually increases, whereas the relative content of aromatic nucleus C=C vibration presents a trend of first increasing and then decreasing. In addition, -CH2- is the majority in the structure of fatty hydrocarbons, and the absorption peak intensity of asymmetric -CH3 stretching vibration increases with the increase in heat-treated temperature. The structure of aromatic hydrocarbons mainly consists of four substituted benzene rings (except for R-303.15 K), in which the relative content of the trisubstituted benzene ring decreases with the increase in heat treatment temperature. With the increase in the heat-treated temperature of medium-rank coal, Dc, fH, fC, and fa show a trend of first increasing and then decreasing, M and IR reveal a trend of first decreasing and then increasing, and CH2/CH3 present a gradually decreasing trend. In conclusion, during the increase in the heat treatment temperature of medium-rank coal, the length of the fatty side chains in the fatty hydrocarbon structure becomes shorter, the number of branch chains continuously increases, and the maturity and condensation degree of organic matter first increases and then decreases. On this basis, further research on the effect of coal gasification suggests combining various technologies such as 13C NMR, XRD, and TG-MS to obtain semi-quantitative structural information of molecules in coal from different perspectives.