It is well-known that many manufacturing parameters affect the quasi-static and the fatigue response of additive manufacturing (AM) parts. In particular, due to the layer-by-layer production, the load orientation, with respect to the building direction, plays a fundamental role for the fatigue response. This paper investigates the fatigue response up to 109 cycles (very high cycle fatigue (VHCF)) of selective laser melting (SLM) AlSi10Mg specimens built in a vertical direction. Ultrasonic tension-compression tests (stress ratio of –1) are carried out on as-built Gaussian specimens with a large loaded volume (2300 mm3). Fracture surfaces are investigated with the scanning electron microscope to analyze the defects originating the VHCF failure. Probabilistic S-N curves are estimated and analyzed. Experimental results confirm that the defect size controls the VHCF response, thus highlighting the importance of testing large risk volumes for a reliable assessment of VHCF behavior. The average value of the VHCF strength is close to that of the hourglass specimen tested in the literature. The variability of the VHCF strength is instead significantly larger, due to the scattered size distribution of the defects located near the specimen surface, which is the most critical region for crack initiation.