Using the ultrasonic fatigue test method, the influence of subjection to plasma nitriding surface modifications on the ultra-high cycle fatigue behavior of Ti-6Al-4V was investigated, then a comparison with corresponding behaviors of the normal Ti-6Al-4V was made. The results show the S-N curve of Ti-6Al-4V with plasma nitriding surface modifications still continuously declines, no conventional fatigue limit exists for Ti-6Al-4V. Plasma nitriding surface modifications enhance surface hardness, but they make the material fatigue strength decrease by about 17 %. The fractography of fatigue failure has been observed by scanning electron microscopy. The observation shows that fatigue failure initiates from internal of specimen after the fatigue life of 108 cycles and fatigue cracks mainly initiate from the surface of specimen before the fatigue life of 108 cycles.