By application of thermomechanical controlled rolling and accelerated cooling, the carbon steel grain refinement is limited to levels of ~ 5 μm in steels. The strain assisted or strain induced transformation could be considered for the refining process. The present work, likewise, deals with grain refinement of medium carbon steel containing 0.45 wt pct carbon having different initial microstructure modified by either thermal and/or thermomechanical treatment (TM) prior severe plastic deformation. In case of TM treated steel, structure refinement was conducted in two steps. Preliminary structure refinement has been achieved due to multistep open die forging process which provided total strain of 3. Uniform and fine recrystallized ferrite structure with grain size of the order of 2-5 μm and with nest-like pearlite colonies was obtained. The further grain refinement of steel samples having different initial structure was accomplished during warm Equal Channel Angular Pressing (ECAP) at 400°C. The steel samples of different initial structure were then subjected to six ECAP pressing passes through die channel angle of 120°. The microstructure development was analyzed in dependence of effective strain introduced (εef ~ 2.5 - 4). Employment of this processing route resulted in extensive deformation of ferrite grains where mixture of subgrains and ultrafine grain was found regardless the preliminary treatment of steel. As straining increases the dynamic polygonization and recrystallization became active to form mixture of polygonized subgrains and submicrocrystalline grains having high angle boundaries. The straining and moderate ECAP temperature caused the partial cementite lamellae fragmentation and spheroidization as straining increased. The lamellae cementite spheroidization was more extensive in TM treated steel samples. The tensile behavior was characterized by strength increase for both structural steel states; however the work hardening behavior was modified in steel where preliminary TM treatment was introduced to modified coarse ferrite-pearlite structure.