The deformation and damage of soft rock roadways in karst mountainous area is serious, which greatly restricts the safe and efficient mining of coal resources. To explore the instability mechanism of soft rock roadway under the influence of mining, the 226 rail cross-cut of Shanjiaoshu Coal Mine in China was taken as an engineering background. The methods of field monitoring and drilling imaging were adopted to analyze the roadway failure characteristics. In addition, the distributions of the plastic zone, surface displacement, and fracture fractal evolution characteristics of the surrounding rock for different stress wave peak and stress wave frequency are compared and analyzed using UDEC software. Then, the combined support scheme of “secondary strong bolting and grouting” is proposed to control the severe deformation of the roadway. The primary support mainly adopts short hollow grouting anchor cable to strengthen the shallow broken surrounding rock within 0–3 m. The secondary reinforced support adopts long hollow grouting anchor cable or constant resistance large deformation anchor cable to fully mobilize the bearing capacity of deep surrounding rock and to ensure the long-term stability of the roadway. On-site monitoring showed that the scheme could effectively control the severe deformation of the roadway, which also provided a reference for other similar roadway support.