Iron-rich phosphoaluminate cement (shortened as PAC) exhibits excellent high temperature resistance characteristic, enabling it to withstand the ultrahigh temperatures required for the in situ combustion (ISC) of heavy oil. The addition of slag could influence its high temperature resistance by altering its hydration products. Hence the thickening time, physical properties, phase components and microstructure of PAC with slag that were subjected to different high temperature environment (315, 550 and 800 °C) were investigated deeply in this paper. The experimental analysis results revealed that PAC had better high temperature resistance than CAC with and without slag. The addition of slag improved effectively the high temperature resistance of PAC. The influencing mechanism of slag were as follows. C2ASH8 formed at 50 °C inhibited the conversion of C(A,P)H10 to C3AH6. C2AS3H, C3AS2H2 and C3(Fe,Al)S3 formed at 315 °C alleviated the rapid release of the compound water. The phase Ca5(PO4)3OH and C2AS was stable in the range of 550–800 °C. In addition, the capillary pore structure of PAC was optimized. Therefore, PAC with slag had the potential to be used for high temperature oil well cementing.