This study aims to improve the efficiency and uneven texture of conventional magnetic abrasive finishing (MAF) of the inner surface of alumina ceramic tubes by changing the trajectory of a magnetic abrasive brush (MAB), presenting a new technology of ultrasonic-assisted magnetic abrasive finishing (UAMAF). The experiments compare the surface quality and material removal between MAF and UAMAF and examine the effects of workpiece speed and frequency on the surface roughness and material removal. The results show that the UAMAF has made the finishing of the inner surface of alumina ceramic tubes efficiently and precisely come true. By altering the test conditions, after 50 min processing, the processing achieves the surface roughness of Ra as fine as 0.03 μm and increases the material removal from 295 to 485 mg. The study also reveals that the frequency and workpiece speed improve the processing in varied degrees and have different finishing characteristics of the surface roughness and material removal.