The extrusion of polymer profile products with complex microcross section is difficult due to the extrudate deformation, especially for the profile with multihollow lumens and inner ribs. In order to investigate the effect of die lip geometry on extrudate deformations, three-dimensional simulations have been undertaken for typical small profile extrusions both inside and outside the die using finite-element method (FEM). The Carreau model was used to describe the shear-thinning behavior of polymer melt. The systematic definitions of the die lip geometric parameters and evaluations of the extrudate deformations were proposed. It was found that the thickness and profile deformations happen asynchronously, and the existence of the inner rib changes the global deformation, which cannot be predicted by a deformation combination of the basic geometries. Among the investigated die lip geometric parameters, the wall thickness ratio has the most pronounced effect on both thickness and external profile deformations of the extrudates, with the maximum variation of more than 80%. The decrease of the hollow ratio significantly reduces the extrudate deformation extent, especially the extrudate external profile and the extrudate thickness of the thin-wall region. Even with uniform thickness, the location and shape of the inner rib also generate extrudate deformations not only on the inner rib but also on the thickness of the outer ring at the region not connected with it, by a minor variation level of 5–25%. Comprehensive understandings on the mechanism of extrudate deformations and effects of die lip geometry were obtained. Some hints for small profile die design were provided accordingly. Numerical results showed qualitative and quantitative agreement with the experiments.