Electron beam melting (EBM) has the advantages of high forming speed, high efficiency, and no pollution in vacuum environment. It is suitable for forming Ti–6Al–4V titanium alloy and has been widely used in aerospace, biomedical and other fields. However, the internal pores, rough surface and residual tensile stress of the asbuilt EBM Ti–6Al–4V titanium alloy components seriously affect the fatigue performance of formed part. Through optimization of printing parameters and post-treatment processes, such as hot isostatic pressing and surface treatment, the fatigue performance of EBM formed parts can be significantly improved. The forming process, microstructure, mechanical properties and typical application status of EBM Ti–6Al–4V titanium alloy are reviewed. The factors affecting fatigue performance are discussed, and some post-treatment methods to improve fatigue performance are summarized. Finally, the future development prospect of EBM technology is prospected.