Metals are trace elements with molecular-scale activity present in human tissue, which is mostly composed of ceramics (bone minerals) and self-assembled polymers (proteins). However, metals and their alloys have dominated the field of structural biomaterials in surgical reconstruction, especially in orthopedics despite recent advancements in nonosseous tissues. Problems with the ongoing preservation of implant integrity have also surfaced as a result of the routine clinical use of a wide range of metal implants. This chapter on metallic implant biomaterials identifies and discusses several significant clinical challenges including the wear of joint replacements due to movement, fatigue failure, and systemic toxicity caused by the release of metal ions from corrosion. The chapter then provides detailed evaluations of biomaterials composed of titanium, cobalt, stainless-steel alloys, and shape memory alloys. Additionally, it explores elements of drug delivery, tissue regeneration, and medicine regeneration for human implants. This chapter delves into the characteristics that influence mechanical integrity and biocompatibility, including corrosion fatigue. Lastly, it offers a summary of the most important issues facing metallic implant biomaterials, with a focus on the latest approaches and techniques. © 2025 Elsevier B.V., All rights reserved.