The microstructural evolution of ferritic 9Cr-1Mo-V-Nb steel, subjected to creep-fatigue at $550^{circ}C$, was evaluated nondestructively by measuring the ultrasonic velocity. The variation of the ultrasonic velocity with the fatigue life fraction exhibited three regions. In the first region ($N/N_f$<0.2), a significant increase in the velocity was observed, followed by a slight increase between the fatigue life fractions of $0.2N_f$ and $0.8N_f$, and then a decrease in the final region. The change of the ultrasonic velocity during creep-fatigue was interpreted in relation to the microstructural properties. This study proposes an ultrasonic nondestructive evaluation method of quantifying the level of damage and microstructural change during the creep-fatigue of ferritic 9Cr-1Mo-V-Nb steel.