Nanostructured titania has been extensively investigated as photocatalytic material and is capable of killing bacteria attached on its surface. The persistent challenge yet is how to effectively promote adhesion of bacteria on its surface for consequent extermination. The study presented here deals with liquid flame-sprayed nanostructured titania-hydroxyapatite (HA) coatings. Addition of HA alleviated phase transformation of titania from anatase to rutile during the coating deposition, reducing rutile to anatase ratio from 9.58 to 1.99%, and precluded effectively aggregation of the nano titania particles in the as-sprayed coatings. Adherence of Escherichia coli bacteria on the coatings showed significant dependence on content of HA, and the increased HA content resulted in enhanced attachment of the bacteria. Examination of the photocatalytic activity of the coatings through decomposition of methylene blue dye in water revealed that addition of HA did not markedly deteriorate the photocatalytic performances of the coatings. The coatings consisting of 10 wt.% HA showed the best photocatalytic activity, which is comparable to that exhibited by immobilized Degussa P25 coatings. The unambiguous evidence provided in this study suggests that the coatings made from combination of biocompatible HA and photocatalytic nano titania have great potential for antibacterium applications.