We investigated the stability of a uniform and stoichiometric 0.6-nm-thick Al2O3 film on a Si(001) surface during high-temperature annealing in ultrahigh vacuum (UHV), under low oxygen pressure (2×10−6, 5×10−6, and 2×10−5 Torr O2), and under high oxygen pressure (5×10−5 Torr O2) conditions. UHV annealing of the Al2O3/Si(001) system at 900 °C drastically degraded the Al2O3 film quality and caused atomic-scale roughness at the Al2O3/Si(001) interface. Voids formed in the oxide film as annealing progressed. A low oxygen pressure ambient during annealing, while more or less maintaining the film stoichiometry, caused atomic-scale roughness at the interface. A high oxygen pressure ambient during annealing maintained the film stoichiometry and thickness. However, this processing condition led to the formation of interfacial Si oxide, which caused substantial SiO volatilization and etching of the Si substrate at the Al2O3/Si(001) interface, thereby inducing nanometer-scale roughness at the interface. These results indicate that high-temperature processing imposes a limitation in controlling the composition of ultrathin Al2O3 films and maintaining the abruptness of the Al2O3/Si(001) interface on an atomic scale.