The objective of this paper is to investigate CO2 emissions in the production of coal sources at the prefecture level and to analyze their spatial distribution and regional differences based on the spatial autocorrelation and standard deviational ellipse analysis. The results indicate that Chinese coal production from 2018 will most likely generate 485.23 million tons of CO2 emissions, and there still exists an obvious gap between the five coal development districts in terms of their CO2 emissions. A significant clustering pattern and positive spatial autocorrelation are revealed in the coal production-based carbon emissions in China. In addition, the spatial pattern of coal production-based CO2 emissions has an obvious central tendency and directional trend, and the ellipse direction is quite consistent with the Aihui–Tengchong Line. Our findings suggest that energy policy-makers should be concerned about the carbon emission effect when implementing regional coal development plans and actively guide the formation of a low-carbon spatial strategic pattern of coal production with a directional distribution of CO2 emissions perpendicular to the Aihui–Tengchong Line.