Eccentric meshing reducers are widely used in agriculture, industrial robots, and other fields due to their ability to achieve a high reduction ratio within a compact volume. However, the contact wear problem seriously affects the service performance of the eccentric meshing reducer, thereby limiting their range of applications. To effectively address this issue, this study involved a stress analysis of the contact pairs and a surface wear analysis of a new eccentric meshing reducer. The wear equation for the contact pairs was derived using Archard’s wear theory, incorporating geometric and material parameters from both the reducer gear contact pair and the spline contact pair. In parallel, a wear simulation was conducted by integrating the UMESHMOTION subprogram with ALE adaptive grids. Additionally, the effects of load amplitudes on contact pair stress and surface wear were systematically investigated. It is revealed that the contact pair stress of the reducer gear was higher than that of the spline contact pair. Furthermore, the internal spline exhibited the highest wear rate, followed by the output shaft gear, external spline, and input shaft gear, in that order. This work provides a comprehensive and in-depth understanding of the wear behaviors of general reducers with small teeth differences and offers valuable scientific references for design optimization, fault diagnosis, and maintenance strategy formulation.