In the internal thread extrusion forming, if the process parameters are not selected properly, the extrusion torque will increase, the extrusion temperature will be too high, or even the tap will break. In order to obtain effective process parameters under certain working conditions, this paper uses a combination of numerical simulation and process experiment to analyze the influence of the bottom hole diameter, extrusion speed, and friction factor on the extrusion torque and extrusion temperature. Through an orthogonal experiment, the significant influence law of different process parameters on the extrusion torque and extrusion temperature was studied, and the order of their influence was determined. Based on the optimal process parameters, numerical simulations and process tests were carried out, and the extrusion effect and related parameters were compared and analyzed. The results show that the extruded thread has clear contour, uniform tooth pitch, complete tooth shape, and good flatness. Compared with before optimization, the maximum extrusion torque has been reduced by 37.15%, the maximum temperature has been reduced by 29.72%, and the extrusion quality has been improved. It shows that the optimized method and optimized process parameters have good engineering practicability.