Despite extensive research on the plastic deformation of materials to enhance their fatigue resistance, the influence of the flow tapping process on the fatigue resistance of drilled and tapped bars remains poorly understood. Herein, the fatigue performance of flow-drilled (friction-drilled) and flow-tapped 316L stainless steel bars was experimentally analyzed and compared with that of conventional material-shearing-based drilling and tapping operations. The effect of flow processes on the material properties was evaluated via microhardness tests and microstructural analyses. The results indicated that the hardness near the holes produced via flow forming was 62 % higher than that of the base metal. Moreover, grain refinement and plastic deformation were observed beneath the thread surfaces. Metallographic observations revealed the occurrence of craters and folds at the crest of the flow-formed threads. Following the ASTM F382-17 standard, four-point bending fatigue tests were performed at three stress amplitudes with a stress ratio of 0.1. No noteworthy differences were observed when the maximum bending moments applied were at 75 % and 60 % of the bending moment at yield. However, when the maximum bending moment applied was limited to 50 % of the bending moment at yield, the average fatigue life of the specimens with machined threads was longer than that of their flow-formed counterparts. Fractographic observations were used to identify the crack initiation regions and elucidate the underlying fracture mechanisms. For both types of specimens, failure originated at the crest of the first thread, beneath the surface of the maximum tensile stress. The flow-processed specimens exhibited secondary cracks at the root of the threads, where grain refinement also occurred. This study provides robust empirical evidence that using flow-forming processes to thread 316L stainless steel does not systematically improve the fatigue resistance of the material surrounding the holes. Furthermore, by optimizing the flow process and eliminating discontinuities, the threading process proposed herein could help improve the fatigue resistance of orthopedic implants.