During the operation of the marine cam–tappet pair, affected by periodic dynamic load, transient velocity, and micromorphology, it usually operates in a mixed lubrication state. Under extreme operational conditions, contact is likely to occur at the asperity of the interface, leading to problems such as stress concentration and dry contact. Considering the transient dynamics and three-dimensional roughness of cam–tappet pair, a mixed-elastohydrodynamic lubrication model is developed in this article, while the effects of surface waviness on the lubrication state are also investigated. The results show that the film thickness can be increased by 0.098 μm, and the coefficient of friction can be reduced by 10.6% when the wavelength ratio ranges from 1/6 to 6. However, when the amplitude exceeds 0.6 μm, the coefficient of friction may reach 0.10. Under conditions of low speed and high load, the film thickness decreases and contact load ratio increases. And about 30% reduction in film thickness is achieved on cam–tappet pair, potentially leading to increased wear or scuffing failure.