Surface coal mining and reclamation have greatly reshaped eastern Kentucky’s landscape affecting its socioeconomic, environmental and climatic aspects. This study examined the land-cover changes, trends and patterns in Floyd, Knott, Letcher, Magoffin, Martin, Perry, and Pike counties from 2004 to 2019. Using a random forest classifier, land cover was categorized into seven major classes, i.e., water, barren land, developed land, forest, shrubland, herbaceous, and planted/cultivated, majorly based on Landsat images. The Kappa accuracy ranged from 75 to 89%. The results showed a notable increase in forest area from 5052 sq km to 5305 sq km accompanied by a substantial decrease in barren land from 179 sq km to 91 sq km from 2004 to 2019. These findings demonstrated that reclamation activities positively impacted the forest expansion and reduced the barren land of the study area. Key land-cover transitions included barren land to shrubland/herbaceous, forest to shrubland, and shrubland to forest, indicating vegetation growth from 2004 to 2019. An autocorrelation analysis indicated similar land-cover types clustered together, showing effective forest restoration efforts. As surface coal mining and reclamation significantly influenced the landscapes of the coalfield counties in eastern Kentucky, this study provides a holistic perspective for understanding the repercussions of these transformations, including their effects on humans, society, and environmental health.