Theoretical analysis and numerical simulation are used to study the influence of different parameters of variable diameter borehole pressure relief technology on the surrounding rock and support. A strain-softening model was established to analyze the intrinsic connection between the parameters of variable diameter boreholes and the evolution of surrounding rock stress, deformation law, and support strength. The results show that: (1) With the increase in shallow borehole diameter, it is easy to cause anchor de-anchoring phenomenon. (2) After the deep borehole diameter is more than 250 mm, it transfers the peak of the shallow vertical stress to the deep surrounding rock (about 16 m away from the coal wall). (3) If the position of the variable borehole aperture is set between the anchorage zone and the stress peak of the roadway, the stress transfer effect is better, and the influence and effective binding force on the surrounding rock is smaller. (4) When the spacing is 1.0 m~2.0 m, the vertical stress starts to transfer to the deep surrounding rock, the deformation of the surrounding rock is smaller, and the reduction in the effective binding force of the anchors is smaller. The result can provide a reference for similar production conditions.