In a previous study, we utilized saturated prewet high titanium heavy slag sand to produce UHPC (ST-UHPC). ST-UHPC has high impact and abrasion resistance. For better ST-UHPC applications, we investigate the mechanism of ST-UHPC under different curing systems from the microstructure and macroscopic perspective in this paper. We prepared ST-UHPC under four maintenance conditions: 20 °C standard curing, 90 °C steam curing, 90 °C dry curing and 210 °C 2 MPa pressure steam curing. Then, we analyzed the hydration product composition, the degree of cement hydration, the C-A-S-H gel microstructure and the substitution of Al3+ for Si4+ in relation to these prepared ST-UHPCs. Compared with standard curing, dry curing at 90 °C accelerated the water evaporation and reduced the hydration degree of ST-UHPC cementite. However, pressure steam curing significantly improved the hydration degree of ST-UHPC cementing material, and increased the MCL and Al[4]/Si of C-A-S-H gel. In addition, pressure steam curing reduced the Ca/Si and promoted the conversion of C-A-S-H cementing to tobermorite. Compared with dry curing at 90 °C, pressure steam curing significantly improved the macroscopic properties of ST-UHPC. The macro-performance difference of ST-UHPC under standard curing and 90 °C steam curing is small. The reason is that steam curing caused the water to be rapidly released in the internal aggregate of ST-UHPC. This resulted in the increase of the interface between the internal aggregate of ST-UHPC and the ST-UHPC cementate. The harmful pores in the ST-UHPC matrix under steam curing were also increased. To sum up, compared with standard curing, dry curing at 90 °C weakened the mechanical properties and microstructure of ST-UHPC, but steam pressure curing increased them. The single steam curing had no significant effect on the mechanical properties and microstructure of the ST-UHPC. Therefore, non-steam and room-temperature moisturizing maintenance should be adopted for anti-abrasive UHPC.