In this paper, an integrated approach of CAD/CAM was presented for the spatial cam with oscillating cylindrical rollers. The relationship between the cam profiles and the meshing element’s surface is established by the conjugate surface theory. In the machining process, the cutter location for the rough and the finish machining using cylindrical-end mill is derived. To avoid interference, the principal curvatures and the principal induced normal curvatures between the cam surface and the cutting tool are analyzed. The geometric error was used as a basis for generating appropriate toolpaths. The postprocessor are developed for converting the cutter location file to the five-axis numerical control program. The generated NC program is verified before actual machining through solid cutting simulation. In order to demonstrate the applicability of the presented method, cam profile was cut using a five-axis machine tool with real material.