The effect of a decrease in the tempering temperature from 770 to 750 °C on the long-term creep behavior of a 10% Cr martensitic steel with 0.008 wt % B and 0.003 wt % N was studied. The evolution of microstructure and precipitation distribution during creep was examined using the interrupted tests under an applied stress of 120 MPa at 650 °C. It was found that a higher dislocation density, a finer lath structure and finer carbides after tempering at 750 °C did not provide higher long-term creep strength than after tempering at 770 °C. The creep rupture time was about 30% shorter. Effect of changes in the dislocation density, lath width, sizes of M23C6 carbides and Laves phase particles, and precipitation of V-rich MX phase on the strengthening contribution at the onset of creep and at the transient, apparent steady-state and tertiary stages was analyzed. The higher dislocation density formed by the tempering at a lower temperature provided a higher climb velocity at the transient creep stage. The higher driving force for recovery was not fully compensated by the higher strength exerted by smaller M23C6 carbides. This led to faster annihilation of the lath boundaries and a decrease in internal stress and, consequently, to an order of magnitude higher minimum creep rate of the steel after tempering at 750 °C as compared to tempering at 770 °C.