Abstract: In order to improve the bioactivity and cytocompatibility of Ti-13Nb-13Zr biomedical titanium alloy, Ti-13Nb-13Zr alloy and 5HA/Ti-13Nb-13Zr composite with hydroxyapatite (HA) content 5wt% were fabricated by spark plasma sintering (SPS) technique and then annealed. The microstructure, mechanical properties, surface wettability, in vitro mineralization behavior, cell proliferation and apoptosis of the two materials were investigated. The results show that the alloy is mainly composed of β-Ti and α-Ti phases, and the composite is mainly composed of β-Ti, α-Ti, HA phases and a small amount of ceramic reaction phases (Ca₃(PO₄)₂, CaZrO₃, CaO). After annealing, the part of α-Ti transforms to β-Ti and the microstructure is more uniform. The addition of HA can refine the grains to a certain extent. The compressive strength, yield strength, yield ratio and elastic modulus of the two materials decrease slightly after annealing. The HA not only strengthens the hydrophilicity and osteoapatite-like formation ability, but also increases cell viability rate and cell apoptosis rate of the composites. Comprehensive analysis, the compressive strength, yield strength and elastic modulus of the 5HA/Ti-13Nb-13Zr are (1744±9) MPa, (1493±12) MPa and (43±1.6) GPa, respectively. Moreover, the 5HA/Ti-13Nb-13Zr composite have excellent bone-like apatite formation ability and the cell viability reaches 99.1%±0.8%. It indicated that the addition of HA significantly improves the bioactivity and cytocompatibility of Ti-13Nb-13Zr alloy.