Intelligent wells armed with the interval control valve (ICV) are more and more widely applied in the oilfields. In an ICV, the metal seal pair composed of the metal seal ring and the sliding sleeve is designed to isolate the produced fluid flow between the casing annulus and the tubing. The evaluation of the metal seals for ICVs is necessary to enhance the reliability. In this paper, the influences of medium pressure and initial interference on the contact mechanical behaviors of the metal seal for the ICV are studied by using finite element analysis (FEA) when both of the metal seal pair elements have roundness errors. The results indicate that when the both long axes of the metal seal pair’s elliptical sections coincide or are orthogonal, the contact stresses on the core area for the seal face present cosine or sine curve distributions. Each distribution curve becomes smoother with the increase of medium pressure, initial interference or the reduction of sliding sleeve roundness error. And for the contact stress distribution curves, the maximum at the peaks and troughs and the average increase with the increase of the medium pressure, the initial interference and the roundness error of the sliding sleeve. Moreover, when the angle between the metal seal pair elliptical sections’ long axes increases from 0 ° to 90 °, the contact stress distribution curves on the core area for the seal face change from cosine to sine type, and the maximum at the peaks and troughs and the average first decrease and then increase. The relationship curves between the maximum or average contact stress and the angle of two long axes are approximately symmetrical about the line θ = 45° . This paper provides a simulation evaluation for the ICV metal seal pair with roundness error.