Abstract: Focusing on the stability requirements of the sand control media under alternating injection and production, a mechanical screen pipe and annular coating sand-filled composite sand control method has been evaluated, optimized, and proposed. To explore its feasibility under alternating injection and production conditions and recommend an optimal solution, a series of simulation experiments on alternating injection and production with coated screen pipes and filled sand composite sand control were conducted. These experiments used fully compacted filling and incomplete filling conditions under different modes. The experiments systematically analyzed the instability and failure mechanisms of the coating layer structure, sand invasion and clogging mechanisms, and the flow characteristics. The results show that the stability, sand control performance, and flow performance of the sand-filled composite coating on the screen pipe meet the stability requirements under alternating injection and production conditions. After multiple cycles of alternating injection and production under different conditions, the surface of the filled and compacted coated consolidation layer showed no peeling or only minor damage, indicating a good ability to resist high-intensity and high-frequency alternating gas injection and production, as well as structural stability. Under compacted filling conditions, there was essentially no sand production. However, under the three incomplete filling conditions, sand production occurred, but the amount and particle size of the sand decreased gradually with the injection and production cycles. Ultimately, the system reached a clogging equilibrium with no further sand production, and the sand control performance met the sand control requirements. Under the conditions of formation sand production, the screen pipe coating composite filling layer exhibited formation sand invasion and clogging. However, alternations between clogging and clearing occurred during production and injection, and the overall permeability decreased with the injection and production cycles. Under typical experimental conditions, after five cycles of alternating injection and production, the permeability of the filling layer with a filling efficiency of 95% decreased by about 25.9%. Improving the filling density and consolidation strength of the coating layer in the outer annular space of the screen pipe is key to ensuring stability, sand control effectiveness, and production capacity.