This study explored the impact of integrating fermented feed into the starter diet of lambs, focusing on growth, health, serum antioxidants, immune markers, rumen fermentation, and microbial communities. Thirty-six ten-day-old female Tail Han lambs were randomly divided into three experimental groups, which were separately fed with alfalfa hay (LA group), tail vegetable fermented feed (LB group), and tail vegetable fermented feed supplemented with 0.1% microbial inoculants (LC group) during the experimental period. This study assessed the influence of fermented feed on various parameters, including growth performance, fiber degradation, rumen fermentation, enzymatic activities, and ruminal histomorphology. The results indicate that compared to the control group, the addition of fermented feed can increase the daily weight gain of lambs. Simultaneously, the addition of fermented feed can enhance the total antioxidant capacity of serum (p < 0.05). The addition of fermented feed promoted the increased height of villi in the duodenum or jejunum of lambs (p < 0.05), and the ratio of villi height to crypt depth in the LB and LC groups was also improved (p < 0.05). The addition of fermented feed increased the richness and diversity of the rumen microbial community in lambs (p < 0.05), primarily increasing the relative abundance of Ruminococcus_1, Ruminococcaceae_UCG-005, Lachnospiraceae, and Lachnospiraceae_NK4A136_group.