The pyrolysis separation of calcium and magnesium from phosphate tailings is an important process due to its high-value resource utilization. In this paper, aiming to address the problems of high energy consumption, a slow decomposition rate and the low activity of decomposition products in the high-temperature pyrolysis of phosphate tailings, the medium-temperature pyrolysis of phosphate tailings under a H2O atmosphere was carried out, and the phase reconstruction and activation of pyrolysis process were discussed. The results showed that compared with N2, air and CO2 atmospheres, the pyrolysis process of phosphate tailings in a H2O atmosphere was changed from two stages to one stage, the starting decomposition temperature was reduced to 500 °C and the decomposition time was shortened to 30 min. The order of the influence of each factor on the pyrolysis of phosphate tailings was temperature > H2O pressure > holding time. Under the optimized pyrolysis conditions, the yield of CaMg(CO3)2 decomposition of phosphate tailings into MgO and CaO was 97.3% and 98.1%, respectively, and the reactivity of MgO was 31.6%. The distribution of Ca and Mg elements in the phosphate tailings after pyrolysis showed a negative correlation, and both of them no longer formed associated compounds; Ca mainly existed in the form of Ca(OH)2, Ca5(PO4)3F, CaSiO3 and CaF2, and Mg mainly existed in the form of MgO, MgF2 and Mg(OH)2.