The potential risk of coal and gas outbursts has increased with the depth of coal mining, posing the threat of heavy casualties, vast economic losses, and harm to the ecological environment. Considering the limitations of existing coal and gas outburst prediction methods, novel indicators or methods are needed. In this study, a fully coupled dynamic drilling gas emission THM model of gas diffusion, seepage, and flow is established, and the reliability of the model was verified by the measured data. The validated model was applied to single-factor and multi-factor impact analysis of dynamic drilling gas emission. The simulation results showed that (1) During the drilling process, the increase in permeability is mainly attributed to the coal seam damage and disturbance caused by the borehole and the coupling effects of the THM model, which increase the porosity around the borehole. Driven by the pressure gradient and temperature gradient, the gas pressure and temperature of the coal seam around the borehole show a conical distribution. (2) In the single-factor analysis, increasing the values of coal seam parameters (initial gas pressure, initial permeability, and initial coal temperature) and drilling parameters (borehole radius) will promote gas emissions in the drilling process to different degrees. The most significant promoting effect is the initial permeability, and the weakest is the initial coal temperature. (3) The response surface analysis results of the four factors show that the interaction between initial coal temperature C and borehole radius D is the least significant, and the interaction between initial gas pressure A and initial permeability B is the most significant. Meanwhile, the established multiple regression model characterizes the relationship between borehole gas emissions and initial coal seam gas pressure, and the idea of using drilling gas emission volume to predict coal and gas outbursts was proposed.