The natural hydroxyapatite/chitosan (NHC) composite is a new synthesized material. The aim of this experiment was to assess the bone tissue compatibility of this NHC composite in vivo. Twenty-four healthy New Zealand rabbits were included in this study. Of those, 20 were used as the experimental group and four as the control group. In the experimental group, animals receive a cranium defect procedure and NHC composite repair. In the control group, animals underwent the cranium defect procedure without NHC composite repair. At 1, 4, 12, 24, and 40 weeks after surgery, the animals were sacrificed and samples were taken and assessed by gross observation, three-dimensional (3D) computerized tomographic (CT) reconstruction, histology and scanning electron microscope. Our results showed that at 1 week after repairing the bone defect with the NHC composite in the experimental group, new bone appeared around the composite and matured gradually. At 24 weeks after surgery, there were little collagenous tissues present between the material and surrounding bones. At 40 weeks after surgery, new bone had grown into the mature bone and total osseointegration had occurred. In the control group, however, no bone defect healing was observed at 40 weeks after surgery. All these results of the present in vivo work suggest that the NHC composite has a good hard tissue biocompatibility and an excellent osteoconductivity. It is suitable for artificial bone implants and frame materials of tissue engineering.