Aiming at the problems of poor structural stability and low service life caused by the traditional forming method of round tube wrapped with iron wire and fixed by spot welding at both ends, this paper proposes to use multi-pass cold drawing and intermediate annealing process to realize the integral forming and precision forming of ribbed tube for nuclear fuel cladding, and microstructure evolution of the ribbed tube during the process is investigated. The stress and strain distribution during cold drawing showed that there were severe stress concentrations at the junction of the rib and tube on the outer surface, which restricted the radial and circumferential metal flow and thus inhibited rib filling. The excessive radial and circumferential metal flow on the inner surface leads to serious rib groove defects, which are more likely to appear during cold drawing compared to rib filling. The effects and mechanisms of process parameters and geometric parameters on the cold drawing forming accuracy of ribbed tube were investigated and applied to multi-pass cold drawing to obtain defect-free ribbed tube. In the multi-pass cold drawing and intermediate annealing process, stainless steel tube produces grain refinement, which is due to the martensite produced in the cold drawing process reverses to austenite in the annealing process resulting in grain split, and the multi-pass cold drawing increase the degree of grain refinement.