The aim of this study was to characterize and compare various titanium (Ti) and hydroxyapatite (HA) coatings on Ti6Al4V, in view of their application on noncemented orthopedic implants. Two innovative vacuum plasma sprayed (VPS) coatings, the first of ultrahigh rough and dense Ti (PG60, Ra=74 microm) and the second of ultrahigh rough and dense Ti coated with HA (HPG60, Ra=52 microm), have been developed, and the response of osteoblast-like cells (MG-63) seeded on these new coatings was evaluated in comparison to: a low roughness and sandblasted (Ti/SA, Ra=4 microm) Ti6Al4V surface; Ti medium (TI01, Ra=18 microm), and high (TI60, Ra=40 microm) roughness VPS coatings; and the relative Ti plus HA duplex coatings (HT01, Ra=12 microm and HT60, Ra=36 microm respectively), also obtained by VPS. PG60 coating presented no open porosity, making it dense and potentially intrinsically stronger. Cell adhesion and proliferation on PG60 was similar to those of the smoothest one (Ti/SA) and adhesion on ultrahigh roughness was lower than the medium- and high-roughness coatings, whereas cell proliferation on PG60 was lower than TI60. The HA coating determined significant increases in cell proliferation at medium and high roughness levels when compared to the relative Ti coating, but not compared to the ultrahigh one; all HA-coated surfaces showed a decrease in alkaline phosphatase activity and collagen I production. Surface morphology and the HA coating strongly affected cell behavior. However, ultrahigh values of roughness are not correctly seen by cells, and the presence of HA has no improving effects.