In the high-speed milling of titanium alloys, the combined application of surface texture and coatings can significantly enhance the performance of cemented carbide tools. Investigating the synergistic effect of surface texture and AlSiTiN coating on tool performance is crucial for advancing the development of their integrated preparation process. Therefore, in this study, a cemented carbide ball-end milling cutter is taken as the research object, and a surface-textured AlSiTiN coating is applied to the rake face. The effects of texture and coating parameters on the milling performance of titanium alloys are analyzed, and a regression model is developed to optimize the relevant parameters. The results indicate that the surface texture effectively reduces the actual contact area between the tool and the chip, serves as a storage space for chips, and enhances the wear resistance of the AlSiTiN coating. The coating thickness significantly affects milling force, milling temperature, and surface wear. An increase in coating thickness improves the hardness and integrity of the coating surface, and it also strengthens the adhesion of the texture to the coating. Additionally, precise control of the laser power plays a key role in reducing the milling temperature, while both the number of scans and the scanning speed significantly influence surface wear. Furthermore, maintaining an appropriate distance from the edge is crucial for enhancing the surface roughness of the workpiece. The optimized parameters for surface texture and coating preparation are as follows: coating thickness ( h) = 3.0 µm, laser power ( p) = 40 W, scanning speed ( v) = 1590 µm/min, number of scans ( n) = 6, texture diameter ( d) = 42 µm, texture spacing ( l) = 143 µm, and distance from the edge ( l 1) = 104 µm. The optimized milling performance of the milling cutter shows a significant improvement.