The twin screw rheo-extrusion (TSRE) is designed to take advantage of the nondendritc microstructure and thixotropic characterization of semisolid-metal slurries and produce simple metal profiles directly from melts. The extrusion equipment consists of a rotor-stator high shear slurry maker, a twin screw extruder, and a die assembly. The process is continuous and has a potential for significantly saving energy, manufacturing cost, and enhancing efficiency. The present investigation was carried out to study the process performance for processing rods of an AZ91D magnesium alloy and the microstructure evolution during processing. The semisolid slurry prepared by the process was characterized by uniformly distributed nondendritic granular primary phase particles. AZ91D rods with uniform and fine microstructures and moderate mechanical properties were produced. For the given slurry making parameters, decreasing extrusion temperature was found to improve microstructures and properties. The mechanisms of particle granulation and refinement and the effect of processing parameters on process performance and thermal management are discussed.