Advances in nanotechnology have led to the development of novel orthopedic implant materials that not only have better cytocompatibility properties but can also be used as unique drug delivery platforms. In the present study, currently used titanium was anodized to possess nanotubular surface structures (80 nm inner diameter and 200 nm deep) capable of drug delivery. Such anodized nanotubular titanium surfaces promote bone cell functions (such as adhesion and differentiation) in vitro and in vivo compared with unanodized titanium. To achieve local drug delivery, anodized titanium with nanotubular structures were loaded with penicillin-based antibiotics using a co-precipitation method in which drug molecules were mixed in simulated body fluid to collectively precipitate with calcium phosphate crystals. Results showed for the first time that such co-precipitated coatings on anodized nanotubular titanium could release drug molecules for up to 3 weeks whereas previous studies have demonstrated only a 150-minute release of antibiotics through simple physical adsorption. Furthermore, drug release using co-precipitation from anodized nanotubular titanium was determined to be a diffusion process dependent on first-order kinetics. In addition, contrary to conventional thinking that penicillin-based drug release should decrease cell functions (including both bacteria and mammalian cells), results of this study showed similar osteoblast (bone-forming cell) adhesion between non-drug loaded and drug loaded precipitated calcium phosphate coatings on anodized titanium. Due to the above, these findings represent a promising surface treatment for titanium that could be used for local drug delivery for improving orthopedic applications and, thus, should be studied further.