The nanotopography of biomedical implants is known to play a pivotal role in the cell-implant interactions for successful clinical implantations. Recently, due to the morphological similarity to natural extracellular matrix, titania (TiO2) nanofibers/nanowires have shown great promise as a preferred platform in the field of biomedical implants. In this study, we first review recent progress pertaining to fabrication techniques for producing TiO2 nanofibrous surface topographies. Subsequently, we outline the effect of this on cellular response, using several examples of current in vitro studies, noting that these remarkable results greatly support the potential use of such a surface as a substrate for implantation. However, further in vitro and in vivo studies will be required to realize their full potential in clinical use. Finally, we anticipate that the future direction in this field will be shaped by better analysis and understanding of cellular interactions with TiO2 nanowires/nanofibers surface structure.