This paper aims to study the surface homogenization and integrity of Ti-6Al-4V alloy by longitudinal-torsional coupled ultrasonic vibration assisted ball-end milling. A method of continuous processing between the flat surface and freeform surface connection is proposed by using ultrasonic vibration assisted ball-end precision milling, during this process, it is not necessary to exchange the cutting tool. The way has been explored for changing the homogenization of surface on Ti-6Al-4V by ultrasonic vibration-assisted milling (UVAM). Cutting experiments employing three parameters, cutting speed, feed rate and depth of cut and two types of machining forms using ball-end milling with UVAM and conventional milling (CM) respectively. The high frequency cutting force, finished surface roughness, topography and residual stresses on the surface and tool wear have been measured by advanced instruments. Particularly, adopting the high frequency cutting force measurement system, it is concluded cutting force in ball-end milling decreased significantly using UVAM as against CM. Moreover, the surface roughness by UVAM with ball-end milling is much better than the CM at a high cutting speed. However, an opposite trend is observed at a low cutting speed. Especially, there is a steep decrease from Ra 0.828 μm average value at 4000 rpm to Ra 0.129 μm average value at 5000 rpm. At the same time, the homogenization of surface roughness and residual stresses decrease significantly in UVAM as compared to which in CM when taking the transversal-longitudinal ratio into consideration. Cutting experiments and measuring results are demonstrated the validity and feasibility of UVAM with ball-end milling, and this method enjoys significant advantages compared to CM process.