Zn-Ag alloys are deemed extremely promising materials for manufacturing biodegradable medical implants. Nonetheless, their practical applications are still constrained by inferior mechanical properties. To tackle this issue, Zn-0.5Ag alloy was alloyed with Mg (0.2 wt.%) and processed by combined equal-channel angular pressing (ECAP) and rolling, with different rolling reductions (40%, 60%, and 75%). ECAP-processed Zn-0.5Ag-0.2Mg alloy exhibited superior mechanical properties to its as-cast counterpart. Subsequent rolling of 40% further enhances the mechanical performance of ECAP-processed Zn-0.5Ag-0.2Mg alloy, with yield strength (YS), ultimate tensile strength (UTS), and elongation (EL) reaching 255 MPa, 309 MPa, and 52%, respectively, surpassing the application requirements. As the rolling reduction increased to 60% and further to 75%, YS and UTS declined, whereas EL rose continuously. The underlying mechanisms for the variation in strength and ductility were elucidated based on microstructure evolution analysis through optical microscopy (OM), scanning electron microscopy (SEM), and electron backscatter diffraction (EBSD) characterizations.