Titanium and its alloys are commonly used in almost all disciplines of medicine because of their sufficient biocompatibility and meeting of mechanical requirements. However, dense metallic biomaterials represent only an interfacial connection with host tissue, may develop stress shielding which causes ingrowth of the fibrous tissue, and are prone to microbial adhesion and development of biomaterial associated infections. Therefore, development of a new, porous titanium biomaterial is proposed to improve an implant's interconnection with bone, provide better stabilization, and reduce the risk of the loss of the implant. In this review, recent findings in porous titanium biomaterials engineering are discussed, including the structural and strengthening aspects of titanium alloys. The porosity and design of porous structures, as well as the optimization process are also described. An extensive part of this section is dedicated to manufacturing processes. The next section of the review is devoted to osseointegration of porous implants and surface treatment processes, whose purpose are antibacterial activity or local drug delivery. Summarizing the article, some future predictions have been presented.