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Cementitious tail backfill (CTB) is a combination of mineral tails, hydraulic cement, and water that is commonly utilized for mineral resource recovery, mine waste management, and ground subsidence avoidance. Once in operation, CTB is exposed to intricate environmental features like moisture, heat, and adjacent rock stress, which meaningfully affect its behavior. Consequently, a thermal-hydro-mechanical coupling mathematical model was developed in the current study to tangibly explore evolution of humidity, heat, and strength features of CTB during the curing process affected by the coupled effect of low relative humidity and ambient temperature. Results indicate that the interaction between low ambient temperature and humidity has notable impacts on CTB’s internal relative humidity, heat, and strength property. Typical examples of these effects on fill include low relative humidity and ambient temperature, which can hinder hydration process in fill’s inner section. This leads to a decrease in the peak temperature of CTB during curing, ultimately impacting the strength formation. In due course, the findings of the current research will enhance the understanding of how CTB responds to circumstances of low temperature and humidity.