Hydroxyapatite porous scaffolds can be used for tissue engineering applications since they can serve as templates for cell adhesion, proliferation and ultimately for tissue repair. One way to address this issue is to evaluate the cell adhesion using several characterization techniques namely, cytotoxicity assays and cell visualization. On the other hand, when using highly macroporous scaffolds some techniques may not be adequate for evaluation, such as MTT. In this work, cytotoxicity assay (MTS), scanning electron microscopy (SEM) and Confocal laser scanning microscopy (CLSM) were used to evaluate cell adhesion in highly macroporous hydroxyapatite scaffolds. It was possible to observe that some techniques were not suitable to evaluate cell adhesion. In addition, it was shown that for this kind of scaffolds, confocal laser scanning microscopy is a powerful tool for cell adhesion and proliferation evaluation.