Hydroxyapatite (HA)-reinforced polymers have been proposed as a method of improving the biological properties of bone cements and implant materials. For example, bone cements based on polymethylmethacrylate (PMMA) have long been used to secure orthopedic implants to the skeleton. This composite could also be used as a polished coating on other materials or in bulk form, shaped or molded, to custom fit a specific clinical need. However, complications may occur as a result of the limited mechanical and biological properties of PMMA. The purpose of this investigation was to determine whether the incorporation of HA in a PMMA matrix would enhance the biological properties of osteoblast response as compared to PMMA alone. Fetal rat calvarial osteoblasts were plated on discs of PMMA, PMMA/HA, commercially pure titanium (CpTi) and tissue culture polystyrene (control). Osteoblast attachment and day 2 proliferation were similar on all implant materials, whereas, day 8 proliferation on PMMA/HA was significantly higher than on PMMA and similar to CpTi and control. Extracellular matrix production was examined by immunohistochemistry which indicated that osteoblasts cultured on PMMA/HA showed a more distinct networked pattern of organized fibronectin. Histochemical staining of mineralization was examined by confocal microscopy which demonstrated a higher degree of mineralization in nodules formed on PMMA/HA as compared to PMMA. Together, these results indicate that the addition of HA in a PMMA matrix improves osteoblast response as compared to PMMA alone. Therefore, the incorporation of HA into a PMMA matrix may be a useful method to provide PMMA materials with enhanced osteogenic properties.