This study investigated the effect of ultrasonic rolling on the fatigue resistance of Ti6Al4V titanium alloy laser welded joints, with an emphasis on crack growth rate. Multiple analyses were conducted on samples subjected to different numbers of rolling passes, including analysis of surface roughness, morphology, cross-section structure, hardness, fatigue fracture, and residual stress. Ultrasonic rolling was found to considerably enhance the life cycle of the sample. One, three, and five rolling passes resulted in fatigue life increases of 17.14%, 46.38%, and 66.61%, respectively, when compared with untreated samples. Treated samples exhibited rough and intricate crack propagation paths on fracture surfaces, along with numerous secondary cracks. Fatigue striation width decreased by 48.6%, 62.5%, and 69.4% for samples receiving one, three, and five rolling passes, respectively. These fatigue striations, which were narrower and more densely distributed, indicate that ultrasonic rolling effectively increases fatigue life. The ultrasonic rolling treatment enhanced fatigue performance and reduced the rate of crack propagation due to changes in surface compressive residual stress, microstructure, microhardness, and improved surface quality. Crack retardation primarily occurred in initial stage of crack propagation and stable propagation stages, whereas inhibitory effects weakened during the final fracture stage due to superposition and offset of the higher driving force with compressive residual stress. In summary, the study demonstrates that treatment via ultrasonic rolling is an effective method for improving fatigue life and fracture toughness in Ti6Al4V titanium alloy laser-welded joints.