Aiming at the demand for fatigue life improvement of 45CrNiMoVA ultra-high strength steel shaft parts, a pre-torsion strengthening process using a combination of two different angles before and after was proposed based on the mechanisms of strain hardening, fine grain strengthening and dislocation strengthening. Through surface integrity measurement, torsional fatigue test and fatigue fracture characterization of the specimens, the main surface integrity factors affecting the fatigue life of the pre-torsion strengthening were analyzed. The results indicated that the grain size was refined and the plastic deformation was increased by the two-angle pre-torsion strengthening compared with the single-angle pre-torsion strengthening. The obtained surface residual compressive stress σx was the main factor affecting the fatigue life of pre-torsion strengthening, and the change in pre-torsion angle results in a significant secondary strengthening layer in the subsurface layer of the material. In summary, the study of the pre-torsion strengthening process with different combinations of angles has a guiding significance for improving the fatigue life of ultra-high strength steel.