The internal thread cold extrusion process is improved to further increase the fatigue life of diesel connecting rod in order to improve its fatigue performance. Based on three-dimensional finite element model, the residual stress distribution around the cold extruded internal thread of 42CrMo4 high-strength steel plate hole structure under different edge distance ratios is analyzed in detail. The multiaxial fatigue life prediction model of thread is established based on stress-strain method, the accuracy and feasibility of the prediction model was further proved by fatigue experiments. The thread surfaces are examined by utilizing the scanning electron microscope, coordinate with the X-ray diffraction method to measure the residual stress of thread, the relationship between the residual stress distribution, surface structure and fatigue life of the extruded thread is revealed. The research shows that the improved fatigue prediction model gives a satisfactory accuracy in predicting the fatigue life, both of the tangential residual stress fields around the extruded thread and the surface structure have a certain influence on its fatigue life, especially when the edge distance ratio is less than 2. The tangential residual compressive stress of the cold extruded internal thread decreases with when the edge distance ratio being smaller, while the depth of the stress zone increases firstly and then decreases. Higher load will greatly reduce the fatigue life and dispersion of the thread, the fatigue life increases linearly with the increase of the edge distance ratio under lower stress level.