TC4 titanium alloy is utilized in aerospace and a wide range of other applications due to its high strength and corrosion resistance, but its poor thermal conductivity and high ductility introduce challenges in machining. In this paper, firstly, a mathematical model of workpiece surface morphology under tilted ultrasonic elliptical vibration cutting (TUEVC) was established based on the tip trajectory and material removal mechanism, and the variation of workpiece surface morphology was investigated at different tool tilt angles θ, and it was found that the tilt θ in a certain range could significantly reduce the surface residual height compared with that of ordinary ultrasonic elliptical vibration cutting (UEVC). Second, the TUEVC experiment of TC4 titanium alloy was carried out to comparatively analyze the changes in the surface morphology, surface profile, and surface roughness of the workpiece under different tilt θ, the effect of each machining parameter (cutting speed, feed, and ultrasonic amplitude) on surface roughness was explored. The experimental results indicate that as the tilt θ changes from 0° to 90° throughout the process, the workpiece surface morphology flatness decreases and then increases. When the tilt angle θ is 45°, workpiece cutting surface roughness is minimized (Sa = 0.157), compared with the ordinary ultrasonic elliptical vibration cutting roughness is reduced by 47.6 % maximum. Both the surface morphology flatness and the surface roughness of the workpiece are at their smallest, whereas the theoretical profile curve and cutting surface profile curve are at their most consistent. Under the same machining parameters, TUEVC can reduce the surface roughness more effectively compared with UEVC, this technique reduces surface roughness by 16 %, 23 %, and 26 % at maximum for different cutting speeds, feeds, and ultrasonic amplitudes, respectively.