Dust pollution in coal mine roadways is an important factor, which affects health and safety production of miners. The long-pressure and short-pulse ventilation system has significant advantages in dust removal, safety, energy saving and operation, and it is a commonly used ventilation method in coal mine roadways. In order to optimize the medium-long pressure short-shot ventilation and dust removal system of coal mine roadways, the Reynolds-averaged N-S equations and the k-ε turbulence model were solved by using FLUENT for flow field analysis. Through numerical simulation, the influence of the wall-attached air duct and the head-on distance, different the radial and axial air outlet ratio, pressure air volume, exhaust air volume and pressure pump ratio on dust concentration and distribution were analyzed. The results show that when the air duct is divided into 8∶2, the air duct is 30 m away from the working surface and the pressure pump ratio is 0.53, the ventilation and dust removal effect is the best, the dust influence is the smallest, and the dust concentration behind the air vent does not exceed 3.2 mg/m³, which meets safety standards. The research results can effectively guide the layout of long-pressure and short-shot ventilation systems under the excavation roadway and improve the excavation environment in the roadway.