Two-step thermal oxidation was proposed for Ti and Ti alloys as a surface-treatment process for preparing an anatase-containing TiO 2 layer. This process consisted of treatment in a CO-containing atmosphere (first step) and subsequent treatment in air (second step). In this chapter, first, the current status of TiO 2 coating onto Ti and Ti alloys for biomedical applications is reviewed; then our recent work on the phase and microstructure of TiO 2 layers prepared on commercially pure (CP) Ti, Ti-25mass%Mo alloy, and Ti-25mass%Nb alloy by two-step thermal oxidation is described. The anatase fraction in the TiO 2 layer was controlled through process parameters such as the second-step temperature. Finally, photocatalytic activity of TiO 2 layers formed on the Ti and Ti alloys is evaluated, including: results of water contact angle, decomposition of methylene blue, and antibacterial effects.