To improve medical device hole inner wall quality and overcome issues of traditional abrasive flow methods—limited fluidity in small holes causing deformation due to high inner wall pressure, and slow processing with low viscosity abrasives—a new method called shear thickening abrasive flow polishing is suggested. It uses shear thickening fluid as the medium. By leveraging the Preston equation and fluid dynamics theory, this study establishes both an abrasive flow dynamics model and a material removal model for the shear thickening abrasive flow machining of small titanium alloy hole workpieces in medical instruments. Utilizing the COMSOL software, the flow field state of shear thickening fluid within small holes is examined under varying flow behavior indexes and flow velocities. The findings demonstrate that shear thickening fluid yields superior polishing effects compared to Newtonian fluid. Elevating the flow behavior indexes facilitates a higher material removal rate on the inner wall surface; however, excessively large flow behavior indexes diminish the uniformity of material removal, thereby hindering the attainment of a high-quality polished surface. Furthermore, excessively large flow behavior indexes can reduce fluidity and consequently lower the efficiency of the polishing process. Conversely, while maintaining a constant flow behavior index, increasing the flow velocity contributes to an enhanced material removal rate and improved polishing efficiency. Nevertheless, as the flow velocity rises, the uniformity of inner wall surface roughness diminishes, posing challenges in achieving a high-quality polished surface. [ABSTRACT FROM AUTHOR]