While the solidification macrostructure of continuous cast billets is an important factor influencing the final performance and rolling yield of oil casing steel, the continuous casting process parameters have a direct influence on the solidification structure. This study simulated the solidification process of the continuous casting round billets of oil casing steel using a cellular automaton–finite element (CAFE) model. According to the simulation results, at a superheat degree of 20–35 K, a casting speed of 1.9–2.1 m/min, and a secondary cooling specific water flow of 0.34–0.45 L/Kg, the solidification structure had a relatively high equiaxed crystal ratio and small average grain radius. Guided by the simulation results, this paper establishes optimal process schemes for producing 26CrMoVTiB steel round billets, comparatively analyzes the equiaxed crystal ratio and central shrinkage of round billets produced according to these schemes, and defines the optimal continuous casting process conditions, which are: superheat degree = 25 K, casting speed = 2.1 m/min, and specific water flow = 0.35 L/Kg. When adopting these process parameters, the 26CrMoVTiB steel round billets demonstrate a tiny central shrinkage and an equiaxed crystal ratio of 45.2%.