In this paper, we study a process for modifying the surface microtopography of the Ti oxide layer using a nanosecond-pulsed laser (NPL). Even now, the mechanism by which hydroxyl groups are generated on the titanium surface treated by NPL is not clear. Hence, we evaluated the surface properties of the NPL defocus distances on pure titanium surfaces, and investigated the relationship between the generation of hydroxyapatites/cell viability and the titanium surface characteristics. The NPL defocus distance was varied from 0 to 4 mm. Defocus distances of 0 and 2 mm generated microtopographical features on the titanium surface, and the resulting surfaces exhibited a greater density of OH groups than the surface treated with a defocus distance of 4 mm. The surfaces treated using defocus distances of 0 and 2 mm were found to be coated with microspherical hydroxyapatite composed of coexisting plate- and needle-like crystals after immersion in simulated body fluid, and alkaline phosphatase activity assays indicated improved cell compatibility. The improvements in biocompatibility and cell compatibility were due to the pocket-like microtopographical structures formed along the processing trace. These pockets contained a large amount of OH groups, and promoted the growth of hydroxyapatite.