Due to the special manufacturing process of cobalt–chromium alloy cardiovascular stent tubes, there are serious surface defects in their inner walls, which affects the therapeutic effect after implantation. At the same time, the traditional processing technology cannot finish the inner wall of a cardiovascular stent tube. In light of the above problems, magnetic abrasive finishing (MAF) equipment for the inner wall of an ultra-fine and ultra-long cardiovascular stent tube is proposed, and MAF technology is used to improve the surface quality of its inner wall. High-performance spherical magnetic abrasive powders are used to finish the inner wall of a cobalt–chromium alloy cardiovascular stent tube with an inner diameter of 1.6 mm and an outer diameter of 1.8 mm. The effects of finishing time, tube rotational speed, feed speed of the magnetic pole, MAPs filling quantity, and MAP abrasive size on the surface roughness and material removal thickness of cobalt–chromium alloy cardiovascular stent tube are investigated. The results show that the surface roughness of the inner wall of the cobalt–chromium alloy cardiovascular stent decreases from 0.485 μm to 0.101 μm, and the material removal thickness of the defect layer is 4.2 μm. MAF technology is used to solve the problem of the poor surface quality of the inner walls of ultra-fine and ultra-long cobalt–chromium alloy cardiovascular stent tubes.