To investigate the annual variation characteristics of soil temperature around the medium-shallow coaxial tube ground heat exchanger, a two-dimensional unsteady heat transfer model for the medium-shallow coaxial tube ground heat exchanger was established. The model was solved based on the finite volume method and validated using experimental data from the project. The research findings indicate that under individual heating and cooling conditions, the circulation mode of outer-in and inner-out has a greater impact on soil temperature at a depth of 100 m, while the inner-in and outer-out mode has a more significant effect on soil temperature at a depth of 500 m. During summer conditions, reverse heat transfer is more likely to occur with the outer-in and inner-out circulation mode. At the end of the first winter (or summer) season, the thermal influence radius of the soil is less than 10 m, but this radius increases over time. At the end of one operational cycle, the soil temperature increases at depths shallower than approximately 300 m and decreases at depths deeper than approximately 300 m. Orthogonal experiments reveal that the inlet water temperature in both winter and summer has a notable impact on temperature fluctuations at a soil depth of 100 m, while the inlet water temperature in summer significantly affects temperature fluctuations at a soil depth of 500 m.