To enhance the application of alkali-activated materials in mine filling, cemented tailings backfill was prepared using slag, fly ash, sodium silicate, and NaOH as primary constituents. The effects of the raw material type and dosage on the backfill were examined through a single-factor experiment. Additionally, response surface methodology (RSM) was utilized to optimize the mixing ratios of the backfill, with a focus on fluidity and compressive strength as key objectives. The evolution of backfill quality and compressive strength under the combined effects of dry-wet and freeze-thaw (DW-FT) cycles was analyzed. The hydration products, microstructure, and pore characteristics of the specimens were analyzed using X-ray diffraction (XRD), scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS), and nitrogen adsorption tests (NATs) across varying cycles. The results demonstrate that the optimal backfill composition includes 47.8% fly ash, 6.10% alkali equivalent, and a 1.44 sodium silicate modulus. The macroscopic behavior of the backfill under DW-FT coupling followed this progression: pore initiation → pore expansion → crack formation → crack propagation → structural damage. After a minor initial increase, the backfill strength steadily decreased. Microscopic analysis revealed that the decline in internal cementation products and the deterioration of pore structure were the primary causes of this strength reduction. Thus, the DW-FT coupling can cause significant erosion of the backfill. The technical solutions presented in this paper offer a reference for solid waste utilization and provide valuable insights into the durability of backfill under DW-FT coupling.