In this study, the high-temperature evolution of eutectic carbides in a medium-alloy steel was investigated as well as their precipitation mechanism. Results revealed that MC and M6C eutectic carbides in the steel appeared during the final solidification due to the segregation of Mo and V and the melt undercooling. These eutectic carbides consist of blocky shapes with varying orientations, and rod-like shapes with the same orientation. Further investigation was confirmed that the carbides (MC and M6C) exhibited an intergrowth behavior. The cooling rate had a direct influence on the secondary dendrite arm spacing (SDAS), which decreased from 180 to 130 μm as the rate ranged from 0.6 to 21.9 °C/min. After holding for 0, 25, 50, and 80 h, respectively, the volume percentage of eutectic carbides exhibited a significant decreasing trend from 2 to 0.2%. Additionaly, the carbides exhibited irregular morphology after holding for 0–50 h, respectively, and which was transformed into the rod-like shape with a small size distributed along the grain boundaries after holding for 80 h. This phenomenon was attributed to the mutual diffusion between Mo, V, and other alloying elements in the carbides and Fe element in the steel matrix.