To address the requirements of high rotational speed, high load-bearing capacity, and extended service life in aviation spindle bearings, a new generation of ceramic ball bearings has been widely adopted due to their low heat generation and high reliability. This study explores the fault evolution characteristics of ceramic ball bearings and compares them with those of steel ball bearings through a series of pre-set fault state evolution and comparative tests. In the experiments, identically sized steel and ceramic ball bearings were subjected to back-to-back pre-set fault testing on the same spindle bearing test rig, with vibration signals used for real-time condition monitoring. The coaxial and identical operating conditions ensured the consistency of the comparison results. The combined time–frequency domain vibration signal monitoring method successfully tracked and obtained fault state evolution curves that align with bearing fault evolution theory. The experimental results indicate that ceramic and steel ball bearings exhibit similar fault evolution patterns, undergoing the evolution stages of “expansion period, maintenance period, decline period, and continued expansion period.” However, the fault evolution rate of ceramic ball bearings is significantly slower than that of steel ball bearings. This study provides valuable insights for further analysis and verification of the load-bearing capacity, full life cycle, and in-service condition-based maintenance of aviation ceramic ball bearings. It also serves as a reference for research in the field of bearing fault diagnosis and condition monitoring.