Abstract: TB8 titanium alloy has been widely adopted in manufacturing medical prosthetics due to its excellent biocompatibility and elastic modulus comparable to human bone. Fretting wear damage constitutes a critical factor affecting its fatigue lifespan. This study systematically investigated the fretting wear characteristics of TB8 titanium alloy before and after ultrasonic surface rolling (USR) treatment under varying rolling forces (600~1 200 N) using a UMT TriboLab multifunctional tribometer. The experimental results demonstrated that USR treatment effectively reduced the fretting friction coefficient of TB8 specimens. Compared with untreated specimens, the average friction coefficient of 1 200 N-treated specimens decreased significantly from 0.489 to 0.209, accompanied by a remarkable reduction in wear volume from 6.15×10⁻⁶ mm³ to 3.18×10⁻⁶ mm³. Wear morphology analysis revealed distinct wear mechanisms: untreated and 600 N-treated specimens exhibited characteristic abrasive wear with parallel grooves and adhesive wear features, while 900 and 1 200 N-treated specimens showed smooth wear surfaces free of plowing marks, indicative of dominant oxidative wear mechanisms.