In this study, the changes in the microstructure and mechanical properties during isothermal heat treatment of cast steel before and after hot deformation were investigated using medium-carbon steel with low alloy content. The microstructural characteristics of the cast and hot-rolled medium-carbon steel under isothermal heat-treatment conditions were examined using optical microscopy and scanning electron microscopy in conjunction with electron backscatter diffraction. The variation in the mechanical properties was evaluated using Rockwell hardness and tensile tests. After maintaining an austenitizing condition at 1200 °C for 30 min, an isothermal heat treatment was performed in the range 350–500 °C, followed by rapid cooling with water. Both the cast steel and hot-rolled steel did not completely transform into bainitic ferrite during isothermal heat treatment. The partially untransformed microstructure was a mixture of martensite and acicular ferrite. At 500 °C, the prior austenite phase changed to Widmanstätten ferrite and pearlite. At 450 °C, bainitic ferrite and cementite were coarsened by the coalescence of ferrite and subsequent diffusive growth. The mechanical properties increased as the isothermal heat-treatment temperature decreased, and the hardness of the cast steel was generally higher than that of the hot-rolled steel. Hardness and strength showed similar trends, and overall mechanical properties tend to decrease as the isothermal heat-treatment temperature increases, but there are slight differences depending on complex factors such as various phase fractions and grain size.