Provided is a high strength seamless stainless steel pipe for an oil well that has excellent low temperature toughness, carbon dioxide gas corrosion resistance, sulfide stress corrosion cracking resistance and sulfide stress cracking resistance. The pipe contains, in mass%, C: 0.05% or less, Si: 0.5% or less, Mn: 0.15-1.0%, P: 0.030% or less, S: 0.005% or less, Cr: 14.5-17.5%, Ni: 3.0-6.0%, Mo: 2.7-5.0%, Cu: 0.3-4.0%, W: 0.1-2.5%, V: 0.02-0.20%, Al: 0.10% or less, N: 0.15% or less, and B: 0.0005-0.0100%, C, Si, Mn, Cr, Ni, Mo, Cu and N satisfying a specified formula and Cu, Mo, W, Cr and Ni satisfying another specified formula, the balance being Fe and unavoidable impurities, and has greater than 45% of martensitic phases, 10-45% of ferritic phases, and 30% or less of retained austenite phases. When a continuous 100 mm<2> region is examined by electron backscatter diffraction (EBSD) considering grains within a 15-degree crystal orientation difference to be the same grain, the maximum crystal grain diameter of ferrite grains is 500 [mu]m or less, and the yield strength is at least 862 MPa.