Beta titanium alloy Ti-35Nb-6Ta-7Zr-0.7O (wt%) was developed as a material intended for the manufacturing of a stem of a hip joint replacement. This alloy contains only biocompatible elements and possesses a very high yield strength already in the cast condition (900 MPa). However, the porosity, large grain size and chemical inhomogeneity reduce the fatigue performance below the limits required for utilization in the desired application. Two methods of hot working, die forging and hot rolling, were used for processing of this alloy. Microstructural evolution, tensile properties and fatigue performance of the hot worked material were investigated and compared to the cast material. Microstructural observations revealed that porosity is removed in all hot-worked conditions and the grain size is significantly reduced when the area reduction exceeds 70%. Static tensile properties were improved by both processing methods and ultimate tensile strength (UTS) of 1200 MPa was achieved. Fatigue results were more reproducible in the hot rolled material due to better microstructural homogeneity, but forging leads to an improved fatigue performance. Fatigue limit of 400 MPa was achieved in the die-forged condition after 70% of area reduction and in the hot rolled condition after 86% of area reduction.