The microstructure and creep behavior of a cast Mg-5Sn alloy with 1, 2, and 3 wt pct Bi additions were studied by impression tests in the temperature range 423 K to 523 K (150 °C to 250 °C) under punching stresses in the range 125 to 475 MPa for dwell times up to 3600 seconds. The alloy containing 3 wt pct Bi showed the lowest creep rates and, thus, the highest creep resistance among all materials tested. This is attributed to the favorable formation of the more thermally stable Mg3Bi2 intermetallic compound, the reduction in the volume fraction of the less stable Mg2Sn phase, and the dissolution of Bi in the remaining Mg2Sn particles. These particles strengthen both the matrix and grain boundaries during creep deformation of the investigated system. The creep behavior of the Mg-5Sn alloy can be divided into the low- and high-stress regimes, with the respective average stress exponents of 5.5 and 10.5 and activation energies of 98.3 and 163.5 kJ mol−1. This is in contrast to the creep behavior of the Bi-containing alloys, which can be expressed by a single linear relationship over the whole stress and temperature ranges studied, yielding stress exponents in the range 7 to 8 and activation energies of 101.0 to 107.0 kJ mol−1. Based on the obtained stress exponents and activation energies, it is proposed that the dominant creep mechanism in Mg-5Sn is pipe-diffusion controlled dislocation viscous glide the low-stress regime and dislocation climb creep with back stress in the high-stress regime. For the Mg-5Sn-xBi alloys, however, the controlling creep mechanism is dislocation climb with an additional particle strengthening effect, which is characterized by the higher stress exponent of 7 to 8.