The titanium alloy Ti-6Al-4V ELI is most commonly used for medical implant products because it is corrosion resistant, high strength, and lightweight. In actuality, the temperature will be very high during the machining of this material. This will accelerate the tool wear and affect the surface roughness. Turning with the Actively Driven Rotary Tool (ADRT) has been proven to decrease the cutting temperature so that it is suitable for machining the Ti-6Al-4V ELI. This study focuses on investigating the surface roughness and morphology of Ti-6Al-4V ELI when turning with the ADRT. The surface roughness was measured using the surface profile tester, while the surface morphology was observed using a Scanning Electron Microscope (SEM). The turning with ADRT parameters consisting of the tool diameter, cutting speed, tool revolution speed, feed, and tool inclination angle were analyzed for their effects on the surface roughness. Results show that the cutting speed and tool inclination angle have a significant effect, with a contribution effect of about 67% on the average surface roughness (Ra). The increasing cutting speed resulted in the increased average surface roughness (Ra). The average surface roughness (Ra) also increased with an increasing tool inclination angle. Moreover, no physical damage was observed, such as cracks, micro-pits, and a white layer on the material’s surface morphology.