The invention discloses a perforation fracturing permeability-improvement method for a high-stress low-porosity coal seam, and belongs to the field of disaster prevention and control of mining working faces of coal mines. The method comprises the steps that firstly, coal body mechanical properties are measured, and related technical parameters such as the perforation depth, coal body crack initiation pressure, the fracturing permeability-improvement radius, the separation distance between drilled holes and the separation distance between perforations are determined; then, a coal seam perforation system is installed, and perforation operation is conducted on the coal seam perforation system; after perforation operation is accomplished, a hydraulic fracturing system is installed, fracturing is started, water is injected, and changes of a pressure value are observed until fracturing operation is accomplished. According to the method, a fracturing structure is additionally arranged in a coal body, elastic potential energy of the coal body can be released effectively, and a preparation is made for rock burst prevention and control work of the working faces; meanwhile, high-pressure water can play a good role in moistening the coal seam, the quantity of dust produced during mining of the coal seam is reduced, creation of a good working environment is facilitated, and physical health of underground workers is protected.