In the present study, the fatigue response of an additive manufactured H13 type hot-work tool steel is investigated across the High Cycle Fatigue (HCF) and Very High Cycle (VHCF) regimes. The primary focus encompasses the interpretation of fatigue strength models, the defect type analysis along with a detailed examination of crack initiation and growth mechanisms. Despite the tremendous development in AM technology, experimental data regarding advanced mechanical properties, and particularly fatigue behavior, are still limited. Here, microstructural analysis of a modified AMed H13 hot-work tool steel, a combination of HCF and VHCF testing methodologies implemented for the characterization of the fatigue behavior, as well as a thorough fractographic analysis of the fractured surfaces were performed. Results are compared with historical data of a conventionally ingot cast and forged grade to assess the influence of the AM process on the fatigue response of H13 hot-work tool steels. It proves to be comparable to the conventionally manufactured grade, showcasing the potential utilization of AM in the production of components used in high-demanding applications, and in hot work tooling applications. However, the type of critical defects identified in the AM grade was found to be process-induced, emphasizing the need to optimize process parameters to reduce both the number and size of defects and also to ensure component reliability and high performance in various industrial applications.