As a new attempt, equal channel angular extrusion (ECAE) of nickel-titanium shape memory alloy (NiTi SMA) tube was investigated by means of process experiment, finite element method (FEM) and microscopy. NiTi SMA tube with the steel core in it was inserted into the steel can during ECAE of NiTi SMA tube. Based on rigid-viscoplastic FEM, multiple coupled boundary conditions and multiple constitutive models were used for finite element simulation of ECAE of NiTi SMA tube, where the effective stress field, the effective strain field and the velocity field were obtained. Finite element simulation results are in good accordance with the experimental ones. Finite element simulation results reveal that the velocity field shows the minimum value in the corner of NiTi SMA tube, where severe shear deformation occurs. Microstructural observation results reveal that severe plastic deformation leads to a certain grain orientation as well as occurrence of substructures in the grain interior and dynamic recovery occurs during ECAE of NiTi SMA tube. ECAE of NiTi SMA tube provides a new approach to manufacturing ultrafine-grained NiTi SMA tube.