Understanding the synergistic effect between topography and vegetation in the underground coal mine is of great significance for the ecological restoration and sustainable development of mining areas. This paper took advantage of unmanned aerial vehicle (UAV) remote sensing to obtain high-precision topographic factors (i.e., digital elevation model (DEM), slope, and aspect) in the Shangwan Coal Mine. Then, a normalized difference vegetation index (NDVI) was calculated utilizing Landsat images from 2017 to 2021, and the NDVI with the same spatial resolution as the slope and aspect was acquired by down-sampling. Finally, the synergistic effect of topography and vegetation in the underground mining area was revealed by dividing the topography obtained using high-precision data into 21 types. The results show that: (1) the vegetation cover was dominated by “slightly low-VC”, “medium-VC”, and “slightly high-VC” in the study area, and there was a positive correlation between the slope and NDVI when the slope was more than 5°. (2) When the slope was slight, the aspect had less influence on the vegetation growth. When the slope was larger, the influence of the aspect increased in the study area. (3) “Rapidly steep–semi-sunny slope” was the most suitable combination for the vegetation growth in the study area. This paper revealed the relationship between the topography and vegetation. In addition, it provided a scientific and effective foundation for decision-making of ecological restoration in the underground coal mine.