Background: Emissions from coal power plants have decreased over recent decades due to regulations and economics affecting costs of providing electricity generated by coal vis-à-vis its alternatives. These changes have improved regional air quality, but questions remain about whether benefits have accrued equitably across population groups. Objectives: We aimed to quantify nationwide long-term changes in exposure to particulate matter (PM) with an aerodynamic diameter ≤2.5μm (PM2.5) associated with coal power plant SO2 emissions. We linked exposure reductions with three specific actions taken at individual power plants: scrubber installations, reduced operations, and retirements. We assessed how emissions changes in different locations have influenced exposure inequities, extending previous source-specific environmental justice analyses by accounting for location-specific differences in racial/ethnic population distributions. Methods: We developed a data set of annual PM2.5 source impacts (“coal PM2.5”) associated with SO2 emissions at each of 1,237 U.S. coal-fired power plants across 1999–2020. We linked population-weighted exposure with information about each coal unit’s operational and emissions-control status. We calculate changes in both relative and absolute exposure differences across demographic groups. Results: Nationwide population-weighted coal PM2.5 declined from 1.96μg/m3 in 1999 to 0.06 μg/m3 in 2020. Between 2007 and 2010, most of the exposure reduction is attributable to SO2 scrubber installations, and after 2010 most of the decrease is attributable to retirements. Black populations in the South and North Central United States and Native American populations in the western United States were inequitably exposed early in the study period. Although inequities decreased with falling emissions, facilities in states across the North Central United States continue to inequitably expose Black populations, and Native populations are inequitably exposed to emissions from facilities in the West. Discussion: We show that air quality controls, operational adjustments, and retirements since 1999 led to reduced exposure to coal power plant related PM2.5. Reduced exposure improved equity overall, but some populations continue to be inequitably exposed to PM2.5 associated with facilities in the North Central and western United States. https://doi.org/10.1289/EHP11605