The lifetime of steam pipelines in long-term operation in coal-fired power plants are limited due to material damage that resulted from creep exposure. In the present study, the authors comparatively assess the damage of ex-service 12% Cr piping steel with varying degrees of exposure while using accelerated creep tests that employ digital image correlation (DIC) as well as microstructural investigation that is based on electron microscopy. The DIC technique, which allows multiple creep curves to be measured at temperatures ranging from 550–600 °C from a single specimen, revealed higher Zener–Hollomon parameters for a high damage material with a high void density when compared to a material with lower damage and lower void density. Both of the material states showed similar hardness values, subgrain sizes, and boundary character, despite the difference in void densities. Slightly higher inter-particle spacing of MX precipitates results in a lower threshold stress of 79 MPa for the high damage steel when compared to 97 MPa for the low damage material. Besides large Laves phase particles (>0.2 µm) that are found in the higher damaged materials that result in solid solution depletion, the most prominent microstructural damage indicator was a lower density of M23C6 precipitates. Therefore, the observations indicate that the Zener–Hollomon parameter and M23C6 particles are good damage assessment indicators between the most extreme damage states and they predict a lower damage level for a medium void density material.