The invention provides a precise rotary table axial and radial runout measurement device and measurement method. The measurement device comprises a wavefront measurement interferometer, a precise rotary table to be measured and a reflecting spherical optical element. The reflecting spherical optical element is installed on the precise rotary table to be measured. The rotating axis of the precise rotary table to be measured passes through the center of curvature of the standard spherical surface of the reflecting spherical optical element. The measurement result through the wavefront measurement interferometer is the coefficient of the Z2th (X inclination), Z3th (Y inclination) and Z4th (off-focus) items of the Fringe Zernike polynomial. The precise rotary table axial and radial runout measurement device and measurement method have the advantages that the device structure is simple, operation is convenient and the measurement precision is independent of the standard sample precision.