Elastic-plastic stress analysis has been performed to evaluate the fatigue life of an autofrettaged pressure vessel containing cross-bores subjected to pulsating internal pressure of 200 MPa. Finite element analyses were used to calculate the residual and operating stress distributions of the pressure vessel due to the autofrettage process and pulsating internal pressure, respectively. Theoretical stress concentration factors of 3.06, 2.58, and 2.64 were obtained at the cross-bore of the pressure vessel due to internal pressure, 50%, and 100% autofrettage loadings, respectively. Local stresses and local strains determined from the elastic-plastic finite element analysis were employed to calculate the failure location and fatigue life of the pressure vessel with radial cross-bores, incorporating the low-cycle fatigue properties of the pressure vessel steel and fatigue damage parameters. Increase in the amount of overstrain by autofrettage process moved the crack initiation location from the inner radius toward a mid-wall, and extended the crack initiation life. Predicted fatigue life of the fully autofrettaged pressure vessel with cross-bores increased about 50%, compared to the unautofrettaged pressure vessel. At the autofrettage level higher than 50%, the failure location and fatigue life of the pressure vessel were not significantly influenced by the autofrettage level.