The Sanhetun tellurium–gold (Te–Au) deposit, located in the Duobaoshan polymetallic metallogenic belt (DPMB) within the eastern section of the Central Asian Orogenic Belt (CAOB), is a newly discovered small-scale gold deposit. The mineralization, with a resource of ≥4 t Au, is mainly hosted in three NNE-trending alteration zones between Early Carboniferous granitic mylonite and Lower Cretaceous volcanogenic-sedimentary formations. The genesis of formation of this deposit is poorly constrained. Here, we report the results of petrographic studies, TESCAN Integrated Mineral Analyzer (TIMA), major and trace element concentrations, and in situ S isotopes of pyrite. The results show that there are four types of pyrite: coarse-grained euhedral Py1, fine-grained quartz-Py2 vein crosscutting Py1, anhedral aggregated Py3, and anhedral aggregated Py4. The pre-ore stage Py1 contains negligible Au, Te, and other trace elements and has a relatively narrow range of δ34S values ranging from −1.20 to −0.57‰. Py2 has higher concentrations of Au and Te and distinctly high concentrations of Mo, Sb, Zn, and Mn with markedly positive δ34S values of 4.67 to 14.43‰. The main-ore stage Py3 contains high Au and Te concentrations and shows narrow δ34S values ranging from −5.69 to 0.19‰. The post-ore stage Py4 displays low Au concentrations with the δ34S values ranging from 2.66 to 3.86‰. Tellurides are widespread in Py3 and Py4, consisting mainly of native tellurium, tetradymite, tsumoite, hessite, and petzite. Especially, tetradymite commonly coexists with native gold. This study highlights the role of Te–Bi–S melt as an important gold scavenger in As-deficient ore-forming fluids.