<p>Biocompatible porous titanium alloys used for hard tissue implants are characterized by a relatively low elastic modulus and adequate strength, which match the mechanical properties of cancellous and cortical bone tissues. Furthermore, the porous scaffold architecture enhances osseointegration through three synergistic mechanisms: promoting bone tissue ingrowth, enabling nutrient/body fluid transport and ensuring implant fixation stability, by biomimicking the interconnected porosity characteristic of natural cancellous bone tissue. This review systematically summarizes sintered titanium alloy foams containing low-cytotoxicity elements (Mo, Nb, Zr, Ta, Cu), focusing on their fabrication methods, microstructural characteristics, mechanical properties, cytocompatibility, antibacterial performance and biocompatibility assessments. Moreover, future research directions are proposed to advance broad applications of these biomaterials.</p> Graphical abstract <p></p>