This study compares the bone responses of old rats when implanted with hydroxyapatite ceramic (HAC)-coated titanium, high-density HAC, and uncoated titanium. Twelve two-year-old Wistar rats were used in this study. Cylindrical implants were placed into each tibia, and the animals were killed seven, 14, 28, or 56 days after implantation. Undecalcified sections were prepared and were then stained with toluidine blue. The healing process was examined histologically, and histomorphometric measurements were made with a computer-based image analyzer to quantify the percentage of implant-bone contact. The results indicated that the HAC-coated implants were superior to the uncoated titanium implants in relation to bone contact. In the cases where the bone-free surface of HAC coating was dissolved, macrophages were often seen on the surface of the implant. Although further longitudinal data are needed to evaluate the decrease of HAC coating, in this animal model, HAC-coated implants may be useful for osseous response in bones of poor quality.