Objective To investigate the status of occupational hazards in large-scale coal mines in Wuchang region, Xinjiang Uygur Autonomous Region (hereinafter referred to as "Xinjiang"). Methods Three large underground coal mines at Wuchang region from Xinjiang in 2022 were selected as research subjects using a purposive sampling method. Result of worksite survey of occupational health, occupational hazards detection, and occupational medical examinations of workers were conducted. ResultsThe main occupational hazards in the three coal mines were dust and noise. The level of free silica in 10 dust samples of workplaces was below 10.0%, indicating that the dust type was coal dust. The exceedance rate of the normalization of equivalent continuous A-weighted sound pressure level to a nominal 8 hours work day was 1.7% (2/119). The exceedance rates for exposure concentration of short term total dust and respiratory dust concentrations from fixed-point sampling were 2.1% (1/47) and 2.2% (1/45), respectively, while the exceedance rate for exposure concentration of time weighted average of respiratory dust from personal sampling was 8.9% (4/45). The occupational medical examination coverage rate among workers exposed to occupational hazards was 64.6% (1 149/1 780), and the abnormality rate was 20.7%. Conclusion The overall situation of occupational hazards in the coal mines in the Wuchang region remains concerning. The dust and noise levels exceed the national occupational health standard in some workplace. Attention should be paid to strengthen the management of dust and noise hazards in large underground coal mines in this region.