A limiting factor of high pressure die cast (HPDC) Mg alloys is the presence of porosity, which has a detrimental effect on the mechanical strength and gives rise to a large variability in the ductility. The application of hydrostatic pressure after casting is known to be beneficial to improve the mechanical response of HPDC Mg alloys. In this study, a combined experimental and simulation approach has been developed in order to investigate the influence of pressurization on the 3D porosity distribution and on the mechanical behavior of an HPDC Mg AZ91 alloy. Examination of about 10,000 pores by X-ray computed microtomography allowed determining the effect of hydrostatic pressure on the bulk porosity volume fraction, as well as the change in volume and geometry of each individual pore. The evolution of the 3D porosity distribution and mechanical behavior of a sub-volume containing 200 pores was also simulated by finite element analysis. Both experiments and simulations consistently revealed a decrease in the bulk porosity fraction and a bimodal distribution of the individual volume changes after the application of the pressure. This observation is associated with pores containing internal pressure as a result of the HPDC process. Furthermore, a decrease in the complexity factor with increasing volume change is observed experimentally and predicted by simulations. The pressure-treated samples have consistently higher plastic flow strengths.