The design of a porthole die is one of the key technologies for producing aluminum profiles. For an aluminum profile with high length–width ratio and small cavity, it is difficult to control the metal flow through porthole die with the same velocity to ensure the die’s strength. In the present study, the porthole die extrusion process of aluminum profile with small cavity was simulated using HyperXtrude 13.0 software based on ALE formulation. The simulation results show for the traditional design scheme, the metal flow velocity in porthole die at every stage was severely not uniform. The standard deviation of the velocity (SDV) at the die exit was 19.63 mm/s. The maximum displacement in the small mandrel was 0.0925 mm. Then, aiming at achieving a uniform flow velocity and enough die strength, three kinds of die structure modifications for the porthole die were proposed. After optimization, desired optimization results with SDV of 0.448 mm/s at the die exit and small mandrel deflection were obtained. Moreover, the temperature uniformity on the cross-section of die exit, welding pressure, and die strength were improved greatly. Finally, the optimal porthole die was verified by the real extrusion experiment. A design method for porthole die for aluminum with a high length–width ratio and small cavity was proposed, including sunken port bridges to rearrange the welding chamber in upper die, increasing the entrance angle of portholes, introducing the baffle plate, and adjusting the bearing length.