Ti6Al4V cranial prostheses in the form of patterned meshes were 3D printed by selective laser melting in an argon environment; using a CO₂ laser source and micron-sized Ti6Al4V powder as the starting material. The size and shape of prostheses were chosen based on actual computer tomography images of patient skull fractures supplied in the framework of a collaboration with a neurosurgery clinic. After optimizations of scanning speed and laser parameters, the printed material was defect-free (as shown by metallographic analyses) and chemically homogeneous, without elemental segregation or depletion. The prostheses were coated by radio-frequency magnetron sputtering (RF-MS) with a bioactive thin layer of hydroxyapatite using a bioceramic powder derived from biogenic resources (Bio-HA). Initially amorphous, the films were converted to fully-crystalline form by applying a post-deposition thermal-treatment at 500 °C/1 h in air. The X-ray diffraction structural investigations indicated the phase purity of the deposited films composed solely of a hexagonal hydroxyapatite-like compound. On the other hand, the Fourier transform infrared spectroscopic investigations revealed that the biological carbonatation of the bone mineral phase was well-replicated in the case of crystallized Bio-HA RF-MS implant coatings. The in vitro acellular assays, performed in both the fully inorganic Kokubo’s simulated body fluid and the biomimetic organic–inorganic McCoy’s 5A cell culture medium up to 21 days, emphasized both the good resistance to degradation and the biomineralization capacity of the films. Further in vitro tests conducted in SaOs-2 osteoblast-like cells showed a positive proliferation rate on the Bio-HA RF-MS coating along with a good adhesion developed on the biomaterial surface by elongated membrane protrusions.