It is very important significance to reveal the control of stress on the recoverability of medium-deep coalbed methane (CBM) resources. The study analyze the types of in-situ stress and their effects on the physical properties and fracturing of coal reservoirs, which based on the data of gas content testing, well testing, and fracturing operations in different regions of Shizhuang North coalbed methane block. The results indicate that the maximum horizontal principal stress (σmax) is 16.74–55 MPa, the average is 30 MPa; the minimum horizontal principal stress (σmin) is 12–32 MPa, the average is 19 MPa; the vertical principal stress (σV) is 24.67–42.18 MPa, the average is 30.97 Mpa. The in-situ stress state of coal reservoir in the eastern gentle slope area principally shows σmax > σV > σmin; the in-situ stress state of coal reservoir in central syncline area shows σV > σmax > σmin; the in-situ stress state of coal reservoir in the western area shows σV ≈ σmax > σmin. Therefore, the in-situ stress have different effects on the physical properties of coal reservoirs in different regions. In-situ stress state in the central area is normal fault mechanisms, which is relatively conducive to high-permeability reservoirs. Conversely, in-situ stress of in the eastern and western areas follows the reverse fault mechanism, which lead to permeability decreases rapidly. Finally, based on the geological parameters and the response characteristics of the fracturing construction curve, it is firstly proposed suggestions for engineering transformation in different stress zones. CBM reservoir in the eastern region is with relatively simple structures and low permeability, and should be developed through conventional fracturing in horizontal wells. The coal seams in the central syncline area are prone to pressure string, so it is necessary to select vertical wells for moderate scale fracturing based on faults and coal body structure. The stress of coal seams in the western fold zone is complex, and is necessary to deploy vertical wells to achieve production potential and avoid fracturing soft coal for the development of CBM. In contrast, coal seams in the western deep gentle slope area is characterized by undeveloped fractures and high stress. Then coal reservoir in the western deep gentle slope area is recommended to horizontal wells and large-scale fracturing to enhance the development potential of CBM reservoirs.