High voltage anodization of titanium in the presence of an electrolytic medium containing calcium and phosphate ions has shown improved osteointegration and biocompatibility compared to untreated titanium. Processing parameters influence the unique porous microstructure developed during anodization. These parameters tailor the specific properties of the surface to achieve improved osseointegration of an implant. In addition, subsequent treatment following anodization further alters the microstructure. Numerous studies have examined the influence of these properties on the cellular response and the mechanical properties in terms of coating adhesion and pull-out strength in bone; however, there are conflicting reports on the cellular responses. This review examines those processing parameters and the related influence on cellular responses and mechanical properties. In addition, this review provides a summary of published reports regarding the work related to the advancement of calcium phosphate coatings achieved through high voltage anodization.