Abstract: Possessing advantages of high specific strength, high harden ability and excellent corrosion resistance, ultra-high strength titanium alloys have been widely used in high-strength structural components such as landing gears, air frames and fasteners. These structural components are often subjected to cyclic loading during service, leading to fatigue failure as a common failure mode. Therefore, in-depth research on the fatigue failure behaviors and mechanisms of high-strength titanium alloys is not only of great scientific significance,but also provides important guidance for practical engineering applications. In this study, we review the existing researches on the fatigue behaviors of ultra-high strength titanium alloys, and discuss the influence of microstructure controlled by deformation and heat treatment on the fatigue damage mechanism. The effects of characteristic parameters such as orientation, content, size and distribution of α phase in bimodal and full lamellar microstructures on the deformation behavior and damage mode during the initiation and propagation stages of fatigue cracks are specifically concerned. Additionally, we focus on fatigue strengthening processes of ultra-high strength titanium alloys and provide prospects for future research on fatigue of ultra-high strength titanium alloys.