The invention belongs to the field of machine tool design, and relates to a combined additive and subtractive manufacturing machine tool, which comprises a body, a workbench, a main shaft, a numerical control system, a subtractive machining module and an additive manufacturing module. According to the combined additive and subtractive manufacturing machine tool, the additive manufacturing module is controlled by the numerical control system to form a basic structure of a required part on the workbench, then the subtractive machining module is controlled by the numerical control system to perform subtractive machining on the basic structure obtained by additive manufacturing, a function of applying ultrasonic vibration to a cutter and a gas cooling function are realized in a subtractive machining process, and the whole combined additive / subtractive manufacturing process is finally implemented. The combined additive and subtractive manufacturing machine tool can be used for realizing the efficient and precise combined additive and subtractive manufacturing of the component, the manufacturability of a complex part is improved, the production cycle is shortened, and the manufacturing accuracy of the complex part is ensured.