Titanium (Ti) with nanoscale structure on the surface exhibits excellent biocompatibility and bone integration. Once implanted, the surgical implantation may lead to bacterial infection and inflammatory reaction, which cause the implant failure. In this work, irregular and nanorod-shaped ZnO nanoparticles were doped into TiO2 nanotubes (TNTs) with inner diameter of about 50 nm by electro-deposition. The antibacterial properties of ZnO incorporated into TiO2 nanotubes (TNTs/ZnO) were evaluated using Staphylococcus aureus (S. aureus). Zn ions released from the nanoparticles and the morphology could work together, improving antibacterial effectiveness up to 99.3% compared with the TNTs. Macrophages were cultured on the samples to determine their respective anti-inflammatory properties. The proliferation and viability of macrophages were evaluated by the CCK-8 method and Live&Dead stain, and the morphology of the cells was observed by scanning electron microscopy. Results indicated that TNTs/ZnO has a significant inhibitory effect on the proliferation and adhesion of macrophages, which could be used to prevent chronic inflammation and control the inflammatory reaction. Besides, the release of Zn ions from the ZnO nanoparticles is a long-term process, which could be beneficial for bone integration. Results demonstrate that ZnO deposited into TNTs improved the antibacterial effectiveness and weakened the inflammatory reaction of titanium-based implants, which is a promising approach to enhance their bioactivity.