The internal-roughed sapphire in a 275-nm AlGaN-based deep-ultraviolet (DUV) LED is fabricated using a laser stealth dicing technique to improve the high-angle extraction. Furthermore, the low-angle extraction is enhanced by depositing a SiO2-antireflection film on the internal-roughed sapphire surface. Compared with conventional DUV LEDs with a light output power (LOP) of 33.05 mW at 350 mA, the LOP of DUV LEDs with internal-roughed sapphire and SiO2-antireflection film increases by 20.85% to 39.94 mW. In addition, combined with finite-difference time-domain simulations, the effect of internal-roughed sapphire on the transmission and light extraction efficiency (LEE) of the DUV LEDs is revealed. The combination of the internal-roughed sapphire substrate and SiO2-antireflection film improves the LEEs of transverse electric (TE) and transverse magnetic (TM) polarized light by 1.6% and 108%, respectively. These results offer the potential for large-scale, low-cost industrial production of high-efficiency DUV LEDs.