An antibacterial and bioactive titanium (Ti)-based material was developed for use as a bone substitute under load-bearing conditions. As previously reported, Ti metal was successively subjected to NaOH, CaCl2, heat, and water treatments to form a calcium-deficient calcium titanate layer on its surface. When placed in a simulated body fluid (SBF), this bioactive Ti formed an apatite layer on its surface and tightly bonded to bones in the body. To address concerns regarding deep infection during orthopedic surgery, Ag(+) ions were incorporated on the surface of this bioactive Ti metal to impart antibacterial properties. Ti metal was first soaked in a 5 M NaOH solution to form a 1 μm-thick sodium hydrogen titanate layer on the surface and then in a 100 mM CaCl2 solution to form a calcium hydrogen titanate layer via replacement of the Na(+) ions with Ca(2+) ions. The Ti material was subsequently heated at 600 °C for 1 h to transform the calcium hydrogen titanate into calcium titanate. This heat-treated titanium metal was then soaked in 0.01-10 mM AgNO3 solutions at 80 °C for 24 h. As a result, 0.1-0.82 at.% Ag(+) ions and a small amount of H3O(+) ions were incorporated into the surface calcium titanate layers. The resultant products formed apatite on their surface in an SBF, released 0.35-3.24 ppm Ag(+) ion into the fetal bovine serum within 24 h, and exhibited a strong antibacterial effect against Staphylococcus aureus. These results suggest that the present Ti metals should exhibit strong antibacterial properties in the living body in addition to tightly bonding to the surrounding bone through the apatite layer that forms on their surfaces in the body.