The control stability and accuracy of quad tiltrotor UAVs is improved when encountering external disturbances during automatic flight by an active disturbance rejection control (ADRC) parameter self-tuning control strategy based on a radial basis function (RBF) neural network. Firstly, a nonlinear flight dynamics model of the quad tiltrotor UAV is established based on the approach of component-based mechanistic modeling. Secondly, the effects of internal uncertainties and external disturbances on the model are eliminated, whilst the online adaptive parameter tuning problem for the nonlinear active disturbance rejection controller is addressed. The superior nonlinear function approximation capability of the RBF neural network is then utilized by taking both the control inputs computed by the controller and the system outputs of the quad tiltrotor model as neural network inputs to implement adaptive parameter adjustments for the Extended State Observer (ESO) component responsible for disturbance estimation and the Nonlinear State Error Feedback (NLSEF) control law of the active disturbance rejection controller. Finally, an adaptive attitude control system for the quad tiltrotor UAV is constructed, centered on the ADRC-RBF controller. Subsequently, the efficacy of the attitude control system is validated through simulation, encompassing a range of flight conditions. The simulation results demonstrate that the Integral of Absolute Error (IAE) of the pitch angle response controlled by the ADRC-RBF controller is reduced to 37.4° in comparison to the ADRC controller in the absence of external disturbance in the full-states mode state of the quad tiltrotor UAV, and the oscillation amplitude of the pitch angle response controlled by the ADRC-RBF controller is generally reduced by approximately 50% in comparison to the ADRC controller in the presence of external disturbance. In comparison with the conventional ADRC controller, the proposed ADRC-RBF controller demonstrates superior performance with regard to anti-disturbance capability, adaptability, and tracking accuracy.