High temperatures and drought are expected to become more frequent in the future and last longer than ever before. To investigate their combined effect on leaves subtending cotton boll (LSCB), an experiment was conducted from 2016 to 2018 using a nonheat‐tolerant cotton cultivar and a heat‐tolerant cultivar. Two temperature regimes with ambient temperature (AT, 31.0/26.4°C) and elevated temperature (ET, 33.4/28.9°C, 2.5°C higher than AT) and three drought treatments with a soil relative water content (SRWC) of 75 ± 5%, 60 ± 5%, and 45 ± 5% were established repeatedly. ET decreased net photosynthetic rate (Pn), initial rubisco activity (4.1.1.39, RuBP) and cytosolicfructose‐1,6‐bisphosphatase (cy‐FBPase; 3.1.3.11) activity, upregulated GhSuSyA, and GhSuSyD expressions, and increased SuSy (2.4.1.13) activity, which led to the decline of the final starch and sucrose contents. Moreover, RuBP, Pn, and starch content all decreased with drop in SRWC levels, but the cy‐FBPase and SPS (2.4.1.14) activity increased, which in turn increased sucrose content. Under combined stresses, when the changing trends of ET and drought effects were the same, the decrease of Pn, RuBP, and starch content was greater than under single stress exposure. However, when the changing trends of ET and drought effects were adverse, the combined effects on indicators such as cy‐FBPase, SuSy, sucrose content were mostly similar to drought stress. These results indicate that the effect of drought on carbohydrate metabolism in LSCB is more prominent than ET. Thus, the drought effect for carbohydrate metabolism in LSCB may need more attention than ET under combined heat and drought stress.