In the last decades, the fatigue lifetime of structural components has increased significantly and in many industrial applications (aerospace, automotive, and energy production industry) is even larger than 10 10 cycles. Therefore, the interest in the Very High Cycle Fatigue (VHCF) behavior of materials has grown rapidly, becoming a subject of primary interest among university and industries. In high-strength steels, VHCF failures generally originate from defects/inclusions; consequently, the steel cleanliness significantly affects the VHCF response. Furthermore, since the probability of finding critical defects in a loaded volume increases with the loaded volume, the loaded volume also significantly affects the VHCF response. This is generally referred to as the "size-effect" in VHCF. The present paper investigates the effects of the manufacturing process and the size-effect on the VHCF response of an AISI H13 steel. Experimental tests were performed on hourglass and Gaussian specimens made of two different types of AISI H13 steels: Unrefined H13 and refined Electroslag Remelting (ESR) H13. The analysis of variance (ANOVA), which was carried out on the test results, and the P-S-N curves showed that the two factors (i.e., the manufacturing process and the size-effect) significantly affect the VHCF response.Metals 2019, 9, 133 2 of 11 processes currently employed for enhancing the steel cleanliness, the ESR is one of the most used in Europe since it permits removal of large detrimental defects to obtain very clean high-strength steels [8][9][10]. Fully reversed tension-compression tests were performed using the two ultrasonic testing machines (loading frequency of 20 kHz) available at DynLab in Politecnico di Torino on hourglass and Gaussian specimens [11][12][13][14] with significantly different risk-volumes to investigate size-effect in VHCF. Size-effect was investigated by the authors in previous papers by considering only unrefined H13 steel [11,[13][14][15]] and refined H13 [16] steel. However, in the present paper, all the experimental results of tests on hourglass (refined and unrefined) and Gaussian (refined and unrefined) H13 steel specimens (69 specimens) are gathered together, with the aim of investigating the interaction between the risk-volume (size-effect) and the manufacturing process (ESR effect) or, in general, the steel cleanliness. The enhancement of the VHCF response that can be attained with the ESR process, the detrimental effect of the size-effect, and the interactions between these two factors were discussed by comparing the inclusion population, the VHCF strength at 10 9 cycles, and the P-S-N curves [17].