This paper proposed an ultrasonic-assisted abrasive flow machining (AFM) method for precision processing to enhance the surface quality of the inner surface of ceramic bearing outer rings. Through a combination of numerical simulation and experimental verification, this study systematically analyzed the influence of three key process parameters—feed pressure, abrasive concentration, and ultrasonic frequency—on the machining results. The results indicated that optimizing the flow channel structure and incorporating an internal contour core effectively improved particle distribution uniformity and machining stress. Appropriately increasing feed pressure and abrasive concentration while reducing ultrasonic frequency facilitated smooth particle flow in recessed areas, thereby achieving higher uniformity in precision machining. Experimental results showed that under the optimal parameter combination (feed pressure of 4 MPa, abrasive concentration of 50%, and ultrasonic frequency of 20 kHz), the surface roughness Ra value of the ceramic bearing decreased from the initial 1.077 μm/1.072 μm to 0.101 μm/0.122 μm, significantly improving surface integrity. Numerical simulations further revealed that the ultrasonic waves increased the kinetic energy and collision frequency of the abrasive particles, effectively enhancing material removal rate and processing efficiency. This study not only validated the advantages of ultrasonic-assisted AFM technology in the precision processing of ceramic materials but also provided theoretical insights into its kinetic mechanisms and process optimization.