Deliberately designed nanostructured materials containing a high density of dopant stabilized interfaces provide energetically favorable sites for the annihilation of defects that form within the crystalline matrix due to irradiation. In this study, we explore the role of dopants on the mechanisms governing this behavior in a nanocrystalline W alloy doped with 20 at.% Ti using heavy ion irradiation experiments. Defect evolution is mapped in situ up to the saturation dose and bridged to extreme dose behavior using ex situ measurements with microstructural analysis focused on quantifying both the defect state and the impact of ion irradiation on the nanocrystalline grain structure. Compared with a nominally pure nanocrystalline W film, the W-20 at.% Ti alloy exhibits smaller defect loops and a delayed saturation dose with a period of irradiation induced grain growth occurring during transient damage accumulation. Microstructural evolution is modeled in the context of cascade-induced thermal spikes and reveals that the alloy evolves to a much finer nanocrystalline grain size relative to the predictions for pure W, indicative of Ti stabilizing the nanostructure against irradiation induced grain growth. In situ mapping of defect evolution during the growth of a single grain confirms the correlation between the global defect density trends and evolution of the microstructure, thus providing insights into the effect of Ti on the grain boundary sink strength through the transient defect accumulation and recovery stages.