The invention discloses a coal-to-oil synthetic wastewater treatment system. The coal-to-oil synthetic wastewater treatment system comprises a regulating tank, a degreasing device, a UASB reactor, anA/O pool, a secondary sedimentation tank and an alkali adding unit; the coal-to-oil synthetic wastewater treatment system has a simple structure and stable operation, is safe and reliable, has low operating costs, avoids environmental damage caused by external discharge of synthetic wastewater, and has great social benefits; and economic benefits of enterprises can be effectively improved, and great popularization value is achieved. The invention further discloses a coal-to-oil synthetic wastewater treatment process. The coal-to-oil synthetic wastewater treatment process comprises the following steps of step one, acid-base regulation, step two, degreasing, step three, anaerobic treatment, step four, anaerobic and aerobic treatment, and step five, sedimentation treatment. The coal-to-oil synthetic wastewater treatment process can realize recycling of water resources and save the water resources; and settled sludge generated by sedimentation is reused in a grease removal tank, and greaseremoval is performed through adsorption of the settled sludge.