Hydroxyapatite (HA) used as a coating for implants can exhibit varying levels of interaction with the biologic environment. The crystallinity of the HA-based coating has been shown to control the rate of dissolution and appears to play a role in the initial cellular interaction with the implant surfaces. An osteoblastic cell attachment assay was employed to examine the cell attachment to untreated and pretreated (pH 5.2, 24 hours) titanium and HA coatings of low (50%), medium (75%), and high (90%) crystallinity. A slightly higher percentage of cell attachment (%CA) was found on untreated and pretreated HA surfaces as compared to the titanium surface. No significant difference could be found in the %CA between the 3 levels of crystallinity. However, higher levels of %CA were observed on pretreated HA surfaces than on untreated HA surfaces (t test, P .05). Elevated calcium and phosphate levels in culture medium did not have any effect on cell attachment. Scanning electron microscopic examinations revealed surface degradation of the HA coating following pretreatment in the simulated inflammatory media (pH 5.2, 24 hours). The results suggest that the altered surface topography may influence the initial cell attachment to HA surfaces. Keywords: cell adhesion, crystallinity, dissolution, hydroxyapatite, osseointegration, osteoblast