To account for or neglect the defect position, i.e. the fatigue initiating defect location, both radially and axially, is evaluated for hourglass-shaped ultrasonic fatigue specimen. The commonly used analytical equations to calculate the stress is compared against a finite element (FE) based approach, which is able to fully considering the stress state at the defect position. Notably, the effects on several common fatigue analyses are evaluated: the fatigue strength distribution, the stress–life and the stress–defect relationships. Fracture mechanical assessment is also performed, for a comprehensive VHCF characterization of the EN-GJS-500-7 ductile cast iron used in the study. The VHCF properties are characterized up to 3⋅108 cycles, using the Step-Stress fatigue testing method under fully reversed loading. The FE-model and Weibull distribution as the choice of fatigue strength distribution, enables size effect evaluation by Weakest-link effective volume with the highly stressed volume method as benchmark. The work shows that it is imperative to use the local stress state at the defect position, as the distribution of failures can diverge largely from the center of the specimen, and that neglecting this causes systematic error and flawed potentially results.