In this work, the effect of an ultrafine-grained (UFG) structure obtained by multiaxial deformation (MAD) on the mechanical properties, fatigue strength, biodegradation, and biocompatibility in vivo of the magnesium alloy WE43 was studied. The grain refinement down to 0.93 ± 0.29 µm and the formation of Mg₄₁Nd₅ phase particles with an average size of 0.34 ± 0.21 µm were shown to raise the ultimate tensile strength to 300 MPa. Besides, MAD improved the ductility of the alloy, boosting the total elongation from 9% to 17.2%. An additional positive effect of MAD was an increase in the fatigue strength of the alloy from 90 to 165 MPa. The formation of the UFG structure also reduced the biodegradation rate of the alloy under both in vitro and in vivo conditions. The relative mass loss after six weeks of experiment was 83% and 19% in vitro and 46% and 7% in vivo for the initial and the deformed alloy, respectively. Accumulation of hydrogen and the formation of necrotic masses were observed after implantation of alloy specimens in both conditions. Despite these detrimental phenomena, the desired replacement of the implant and the surrounding cavity with new connective tissue was observed in the areas of implantation.