Alumina is a polymorphic bioceramic that has been extensively investigated for application in bone regeneration. Dense α-alumina has been considered a suitable biomaterial for dental and orthopedic implants due to its superior mechanical properties. However, its use is limited due to its high inertia in a biological environment. Recent investigations have focused on its distinct phases and surface characteristics through the control of morphology, physical properties, and chemical composition to enhance bioactivity. This article presents a brief review of the developments in porous α-alumina and amorphous-γ-alumina transition. Most studies have shown that composites and alumina coated with bioactive materials, high surface area, and hydroxylated surface can significantly improve biological properties. Cellular responses such as fixation, growth, and proliferation, as well as biomineralization, are the main studies to validate improvements in bioactive properties.