The U-shaped geothermal well, as a method for extracting medium-deep geothermal energy, is considered significant for enhancing the energy utilization efficiency of geothermal reservoirs. Geological and reservoir data from the Huangling area in Shaanxi Province were used to establish a numerical model of a U-shaped geothermal well with a depth of 3 500 meters. Field experiment cases were simulated and validated to investigate the heat transfer characteristics of U-shaped geothermal wells and the impact of related factors on thermal extraction efficiency. The effects of well type, reservoir geothermal gradient, and operational conditions on thermal extraction efficiency were analyzed, and the optimization of well type and parameters was further evaluated. The results indicate that U-shaped geothermal wells achieve higher thermal extraction efficiency compared to other types, particularly in areas with high geothermal gradients and depths exceeding 3 000 meters. Within the parameter range of this study (injection flow rates of 40, 60, 80, 100, and 120 m³/h, and injection temperatures of 20, 25, 30, 35, and 40 ℃), it was found that a larger temperature difference between the inlet and outlet fluids of the U-shaped geothermal well leads to a higher heat transfer rate. The optimal injection flow rate and temperature for U-shaped geothermal wells in the study area were determined to be 100 m³/h and 20 ℃, respectively. The selection of the injection flow rate should consider the requirements for outlet temperature, thermal extraction power, and the power consumption of the circulating water pump. The research findings are expected to provide guidance for optimizing medium-deep geothermal extraction in the region.