The conventional sintering process of municipal solid waste incineration (MSWI) fly ash is always energy intensive. The process forms a cracked structure because of the difficulty in forming the liquid phase to enhance the mass transfer process. Therefore, exploring a new disposal method to simultaneously decrease the sintering temperature and improve the mechanical and heavy metal leaching properties of sintered samples is necessary. In this study, a pressure-assisted sintering treatment was introduced to dispose fly ash by varying the chemical composition and mechanical pressure at relatively low temperatures (300–500 °C). The results revealed that the compressive strength of treated samples increased with the CaO/SiO2 molar ratio increasing from 0.5 to 1.0, and a maximum value of 238.28 ± 8.50 MPa was obtained. The heavy metal leaching concentration results demonstrated a low risk of contamination in the treated samples. Microstructure analyses suggested that the densification process was enhanced with increased mechanical pressure, and the formed calcium silicates and aluminosilicates positively affected the compressive strength. Moreover, smaller crystal lattices were observed during aggregation formation, suggesting the restraint of anomalous crystal growth, which accelerated the densification process and increased the compressive strength. Moreover, the mass transfer process during the pressure-assisted sintering process was enhanced compared with the conventional thermal process, which was reflected by the transformation of elements from homogeneous to heterogeneous distribution. Therefore, the improved mechanical properties and leaching behavior of heavy metals were attributed to the densified microstructure, formation of new minerals, and enhanced driving force during the pressure-assisted sintering process. These findings suggest that pressure-assisted sintering is a promising method for maximizing the reutilization and minimizing the energy consumption simultaneously to dispose fly ash.