Titanium and its alloys are popular materials for medical application, particularly in implant devices, where high mechanical properties and osseointegration are critical factors for successful implantation. In this work, the progress in the studies of nanostructured commercially pure Grade 4 titanium (nanoTi) is demonstrated, in which an ultrafine-grained structure with nanoscale grain size is formed using severe plastic deformation processing. Nanostructured Grade 4 Ti has a very high strength, and its physical nature and strengthening mechanisms are analyzed herein. NanoTi proved also to have very high osseointegration during in vivo experiments. At the same time, the highest biofunctionality is demonstrated by the etched nanoTi samples with pronounced surface roughness, the latter being revealed from precise roughness measurements. The present study provided convincing evidence of accelerated bone formation on nanoTi, which is very promising for manufacture of dental and maxillofacial implants. © 2024 Wiley-VCH GmbH.