The aim of this study was to investigate the effect of ultrasonic stress germination (USG) on total phenolic contents (TPC), total flavonoid contents (TFC), the phenolic compositions, and antioxidant activities of black highland barley (BHB). The USG processing parameters, polyphenol profile, phenolic compositions, and antioxidant activities were explored after USG. Results showed that the optimal USG parameters were as follows: 350 W ultrasonic pretreatment power, 30 °C ultrasonication temperature, 25 min ultrasonication time, and 64 h germination time. Under these conditions, the total phenolic content (688.84 ± 5.30 mg/100 g) and total flavonoid content (59.23 ± 0.45 mg/100 g) of BHB were increased by 28.55% and 10.15%, respectively, compared to the untreated samples. In addition, the USG treatment could more effectively enrich bound phenolic acids and free flavonoids, among which the content of catechin was significantly increased by USG and was the main characteristic substance. Moreover, the USG treatment could improve the antioxidant activity and had a higher antioxidant potency composite index (APC index) (97.91%) of BHB. These results indicate that USG might be an effective method to enrich polyphenols and improve antioxidant activity in BHB.