Titanium and its alloys are cornerstone biomaterials due to their high strength-to-weight ratio, excellent fatigue and corrosion resistance, biocompatibility, and ability to osseointegrate with bone. Their relatively low elastic modulus compared to stainless steels and Co–Cr alloys further enhances their suitability for biomedical applications. Performance is continually improved through alloy design (tailoring α and β phases), advanced manufacturing methods such as CNC machining and additive manufacturing, and surface engineering approaches. In particular, the formation of a stable TiO₂ layer promotes corrosion resistance and cell attachment, while coatings and nanotexturing enhance osseointegration and provide antibacterial functionality. These attributes enable widespread use in orthopedic, dental, and cardiovascular implants. Emerging developments include smart implants with embedded sensors, multifunctional surfaces, and data-driven alloy design, aiming to further optimize mechanical performance, biological response, and long-term reliability. This review summarizes the processing techniques, properties, applications, and recent advances in titanium-based biomaterials.