In recent years, nanostructured oxide films on titanium alloy surfaces have gained significant interest due to their electrical, catalytic and biological properties. In literature, there is variety of different approaches to fabricate nanostructured oxide films. Among these methods, anodization technique, which allows fine-tuning of oxide film thickness, feature size, topography and chemistry, is one of the most popular approaches to fabricate nanostructured oxide films on titanium alloys, and it has been widely investigated for orthopedic applications. Briefly, anodization is the growth of a controlled oxide film on a metallic component attached to the anode of an electrochemical cell. This review provides an overview of the anodization technique to grow nanostructured oxide films on titanium and titanium alloys and summarizes the interactions between anodized titanium alloy surfaces with cells in terms of cellular adhesion, proliferation and differentiation. It will start with summarizing the mechanism of nanofeatured oxide fabrication on titanium alloys and then switch its focus on the latest findings for anodization of titanium alloys, including the use of fluoride free electrolytes and anodization of 3D titanium foams. The review will also highlight areas requiring further research to successfully translate anodized titanium alloys to clinics for orthopedic applications.