In this paper, the microstructure and mechanical properties of heavy-wall seamless bend pipe after quenching at different tempering temperatures, including 550 °C, 600 °C, 650 °C, and 700 °C, were studied. Microstructure and dislocations observations were characterized by means of an optical microscope, a scanning electron microscope, a transmission electron microscope, and X-ray diffraction. As the tempering temperature increases, the dislocation density in the test steel gradually decreases, and the precipitation behavior of (Nb, V)(C, N) increases. The sample tempered at 650 °C exhibits a granular bainite structure with a dislocation cell structure and a large number of smaller precipitates. The yield platforms of tempered samples at 650 °C and 700 °C are attributed to the pinning effect of the Cottrell atmosphere on dislocations. The sample tempered at 650 °C not only presents the highest strength, but also the highest uniform elongation, which is attributed to the higher strain-hardening rate and instantaneous work-hardening index. This is closely related to the multiplication of dislocations, the interaction between dislocations and dislocations, and the interaction between dislocations and precipitates during plastic deformation of the 650 °C-tempered samples with low dislocation density, which delays the occurrence of necking.