Ti-6Al-4V ELI (extra low interstitials) was processed by equal channel angular pressing in order to obtain an ultrafine-grained (UFG) microstructure which is known to enhance the fatigue behavior of metallic materials. Fatigue properties of UFG Ti-6Al-4V ELI were studied by strain and stress controlled fatigue tests. UFG Ti-6Al-4V ELI shows an improvement of the fatigue behavior compared to conventional grain (CG) size counterpart. Microstructural investigations prior to and after fatigue testing confirm a high structural stability of the UFG material. Hence, the UFG alloy has a high potential for prospective use in biomedical and engineering applications.