Municipal solid waste (MSW) incineration fly ash (IFA) can be potentially reused as a substitute for some raw materials, but treatment for detoxification is indispensable owing to high contents of heavy metals in fly ash. In the present work, due to excessive leaching concentration of lead (Pb), a moderate thermal treatment with sodium hydroxide (NaOH) addition was employed to stabilize Pb in IFA. The moderate thermal treatment was performed under relatively low temperature ranging from 300 to 500°C and at retention time from 1 to 3 h with NaOH addition in a range of 1 to 9%. Leaching results showed that leaching concentrations of Pb in IFA leachates decreased below the standard for hazardous waste identification (5 mg/L) in China under all treatment scenarios. With the increase of temperature, retention time and the amount of NaOH, the concentration of Pb were further suppressed in IFA leachates. Especially, at 500°C for 3 h with 9% NaOH addition, the concentration of Pb dropped to 0.18 mg/L, which was below the standard for sanitary landfill (0.25 mg/L) in China. In thermal process, needle-like crystallites melted to form granules and clumps with compacter structure and less pores. After the thermal treatment, water-soluble and exchangeable fractions of Pb significantly decreased. Therefore, the thermal treatment coupled with NaOH could be applied to realize the environmentally sound management of MSW IFA.