To improve the carbonate gas reservoir development and production, highly deviated wells (HDW) are widely used in the field. Production decline analysis of HDW is crucial for long-term gas reservoir development. However, it is a new challenge to incorporate the complex pore structure of naturally fractured-vuggy carbonate gas reservoirs and evaluate the production performance of HDW. This paper presents a semianalytical model to analyze the pressure and production behavior of HDW in naturally fractured-vuggy carbonate gas reservoirs, which consist of fractures, vugs, and matrix. The primary flow occurs only through the fracture and the outer boundary is closed. Introducing pseudopressure and pseudotime, the Laplace transformation, Fourier transformation, and its inverse and Stehfest numerical inversion were employed to establish a point source and line source solutions. Furthermore, the validity of the proposed model was verified by comparing a field data from the Arum River Basin in Turkmenistan. Finally, the effects of major parameters on the production decline curves were analyzed by using the proposed model and it was found that they had influences at different stages of gas production history and the sensitivity intensity of each parameter was different. With its high efficiency and simplicity, this semianalytical model will serve as a useful tool to evaluate the well production behavior for the naturally fractured-vuggy carbonate gas reservoirs.