The beneficial effects of Sr-and Mg-doped hydroxyapatite (HAp) on osteoblast proliferation and bone regeneration have been investigated in the past, and the antibacterial ability of Zn ions is well known. However, HAp coatings doped with these three elements via thermal spraying have not yet been investigated. In this study, HAp powder was synthesized at different pH values (4, 6, 8, and 10) and calcined at different temperatures (200, 400, 600, 800, and 1000 °C) to obtain HAp with the highest purity. Subsequently, strontium-, magnesium-, and zinc-doped HAp powders were synthesized at the optimal pH value and calcination temperature. The HAp powder was then coated onto Ti disks using atmospheric plasma spraying (APS) or vapor-induced pore-forming atmospheric plasma spraying (VIPF-APS) techniques at different working currents (350, 400, and 450 A) and spraying distances (10 and 15 cm). X-ray diffraction, Fourier transform infrared spectroscopy, and scanning electron microscopy equipped with energy-dispersive spectroscopy were used for material characterization to determine the optimal parameters. With these optimal coating parameters, HAp, Zn-HAp, SrMg-HAp, and ZnSrMg-HAp powders were deposited onto the Ti disks using VIPF-APS and named HAp-Ti, Zn-HAp-Ti, SrMg-HAp-Ti, and ZnSrMg-HAp-Ti, respectively. The in vitro bioactivity of these four groups was evaluated using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and alkaline phosphatase (ALPase) activity assay. Besides, the antibacterial activities against Prevotella nigrescens, Porphyromonas gingivalis, and Fusobacterium nucleatum were assessed. The results showed that the purity of HAp synthesized at pH 10 and 800 °C was 98.40%. A porous coating without cracks was obtained at a 10 cm spraying distance and 400 A working current using VIPF-APS. SrMg-HAp-Ti and ZnSrMg-HAp-Ti resulted in higher osteoblast proliferation and ALPase activity than the control. Moreover, both Zn-HAp-Ti and ZnSrMg-HAp-Ti exhibited antibacterial activity against the three bacteria. Therefore, ZnSrMg-HAp has potential as a coating for biomedical materials due to its ability to reduce bacterial infection and enhance osseointegration.