• Ultrasonic microfluidics under continuous cooling crystallization was introduced as a process intensification approach. • The process was intensified by precipitating an average ezetimibe 101 ± 1.1 nm nano-drugs under best parametric condition. • Ultrasonic frequency, flow rate ratio, and bath temperature were the significant factors for the response EZB PS using PBD. The current research focuses on the antisolvent precipitation of Ezetimibe (EZB) via microfluidics under continuous ultrasonic cooling crystallization. One factor at a time was applied to study the effect of parameters: organic-aqueous flow rate ratio (1:2–1:5), EZB concentration (2.5–12.5, mg/mL), polymer concentration (0.025–0.3, % w/v), ultrasonic frequency (22–42, kHz), ultrasonic bath temperature (10–25, °C), ultrasonic amplitude (20–100, %), confluence angle of micromixer inlet (90°–180°) on the particle size (PS, nm), % yield, % encapsulation efficiency (% EE), and % dissolution rate (% DR). A PBD (Plackett–Burman design) was also employed for the screening studies of influencing factors for aforementioned responses. PS, Zeta potential (ZP, mv), Field Emission Gun Transmission Electron microscope (FEG-TEM), and X-ray diffraction (XRD) were analyzed for raw EZB and nano-precipitated EZB. An average EZB PS of 101 ± 1.1 nm, PDI of 0.027 ± 0.01, 80 ± 1.7 % yield, 78.83 ± 0.5 % DR, 90.67 ± 0.1 % EE, and −20 mV ZP were obtained under best parametric condition. FEG-TEM revealed the final nano EZB morphology was likely to be elongated cuboidal or rod-shaped. An approximately 5-fold increase in %DR was observed for the confluence angle of 90° (├ shaped) micromixer as compared to raw EZB. However, 94.14 % decreament in avg EZB PS was achieved for the confluence angle of 90° (├ shaped) micromixer and utilizing ultrasonic microfluidic system (USMS) under cooling crystallization as a process intesification approach. [Display omitted] [ABSTRACT FROM AUTHOR]