Vernon Unsworth, 63, told The Times that the billionaire's claims he moved to Thailand to find a child bride are "100 per cent" false and "very hurtful."
Libel is a criminal offence in Thailand and could land Musk jail time.
Vernon, a financial broker from St Albans, is also considering defamation proceedings in the US and UK, reports The Times.
His lawyer, Mark Stephens, said: "Just as we get a series of legal proceedings drafted, Mr Musk adds another libel to it.
"This has been going since July and he has not produced a scintilla of evidence. He may have money but he does not seem to have much class."
Vernon fears PayPal co-founder Musk could hire private investigators to dig up dirt on him.
He told the paper: "I've been told today to be very careful because this guy may do anything to make my life difficult."
The Brit also refuted Musk's claims he had visited Pattaya or any other Thai area known for sex tourism.
Earlier his girlfriend of seven years Woranan Ratrawiphukkun, 40, also slammed the claims.
The local politician and businesswoman – known as Tik – told the Thai news website Coconuts: "The news about him being married to a 12-year-old child is laughable."
Tik, who shares a rural home with Unsworth near Chiang Rai, added: "Vern is a kind person. He rarely has an argument with anyone, and everybody loves Vern.
"We've spent our life together for seven years – he's a good man and such a gentleman. He thinks of others before himself. I cannot comment further. I don't have anything to say to him [Musk].
"I know what kind of person Vern is. If he wasn't a good man, we wouldn't still be together after all these seven years."
Tik, who runs a nail salon, said she met Vernon when she travelled to London to make investments.
Asked about whether he would sue Musk, she said: "I have no details. I'll have to wait until Vern gets here. If your husband was accused of this, would you sue?"
Musk initially apologised for calling Vernon a "paedo" after he mocked his attempts to use a mini-sub in the Thai cave rescue of the stranded football team.
But this week he reignited the feud, telling a BuzzFeed reporter in an email: "I suggest that you call people you know in Thailand, find out what’s actually going on and stop defending child rapists, you f***ing asshole.
"He's an old, single white guy from England who's been travelling to or living in Thailand for 30 to 40 years, mostly Pattaya Beach, until moving to Chiang Rai for a child bride who was about 12 years old at the time.
"There's only one reason people go to Pattaya Beach. It isn't where you go for caves, but it is where you'd go for something else.
"Chiang Rai is renowned for child sex-trafficking."
He added: "As for this alleged threat of a lawsuit, which magically appeared when I raised the issue (nothing was sent or raised beforehand), I hope he f*****g sues".
His latest outburst comes after a US-based lawyer for Unsworth sent Musk a letter – by Fedex and electric mail – notifying him of a possible lawsuit.
Musk – worth a reported $20bn – posted a string of bizarre series of tweets, some of which he later deleted, suggesting the expert had exaggerated his role in the rescue.
He hit back: "You don’t think it’s strange he hasn’t sued me? He was offered free legal services."
Unsworth is a British expat and caver who lives near the Tham Luang tunnel network where the boys were trapped.
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