Based on the d-electron alloy design theory, a new metastable β-type titanium alloy for biomedical applications, Ti-21Nb-7Mo-4Sn (wt.%) was designed in this article. This theory predicted this alloy was a metastable single β-type titanium alloy with low elastic modulus at room temperature, and the β-phase transition (β to α″) would be easy to occur during the cold rolling. The evolution of microstructure and mechanical properties of this alloy during cold rolling plus annealing were investigated by means of x-ray diffraction, optical microscope, transmission electron microscope and mechanical properties test. The results indicate that only β phase can be identified in this alloy before cold rolling, while a large amount of lath martensite (α″ phase) appears after cold rolling due to stress-induced martensitic transformation, which is in accordance with the prediction of the d-electron alloy design theory. The recrystallization nucleation occurs preferentially in the martensite lath region during the subsequent annealing process, and this region forms a large number of nano-crystals and microcrystals, showing that cold rolling plus annealing can become a new process for refining grains. Compared with casting and cold rolling samples, the annealing materials at 923 K for 10 min have excellent comprehensive mechanical properties with lower elastic modulus (58 GPa) and higher elastic recovery rate (35.39%).