A multi-grain conical grinding head capable of performing both peripheral and end-face grinding was created in Abaqus to simulate conventional grinding (CG) and axial ultrasonic-assisted vibration grinding (AUVAG) on Ti-6Al-4V alloy. A comparative analysis was conducted to examine the effects of key grinding parameters on the fluctuation amplitude and mean value of grinding forces in CG and AUVAG. The mechanism of ultrasonic vibration’s influence on grinding forces was analyzed, and a theoretical model for normal and tangential grinding forces in peripheral grinding of Ti-6Al-4V was established. Additionally, the surface morphology of CG and AUVAG was analyzed. The study found that the fluctuation amplitude of grinding forces in both AUVAG and CG increases with the axial grinding depth, feed rate, ultrasonic amplitude, and ultrasonic frequency, while it decreases with increasing spindle speed. However, the fluctuation amplitude in AUVAG is greater than that in CG. The average grinding forces in both CG and AUVAG increase with the grinding depth and feed rate, and decrease with the spindle speed. Compared to CG, the mean F x ([Formula: see text]) and F y ([Formula: see text]) are lower in AUVAG, while the mean F z ([Formula: see text]) is higher. Under different axial grinding depths, the maximum reduction in [Formula: see text] and [Formula: see text] for AUVAG is 4.70% and 5.18%, respectively, while the maximum increase in [Formula: see text] is 77.48%. At different feed rates, the maximum reduction in [Formula: see text] and [Formula: see text] for AUVAG is 3.02% and 21.01%, respectively, while the maximum increase in [Formula: see text] is 81.67%. Under different spindle speeds, the maximum reduction in [Formula: see text] and [Formula: see text] is 7.20% and 17.82%, respectively, and the maximum increase in [Formula: see text] is 281%. As the ultrasonic amplitude and frequency increase, [Formula: see text] significantly rises, but the effect on [Formula: see text] and [Formula: see text] is weak. AUVAG improves the surface quality of the specimen.