Tissue engineering has been enhanced by advance in biomaterial nature, surface structure and design. In this paper, I report specifically vertically aligned titania ($TiO_2$) nanotube surface structuring for optimization of titanium implants utilizing nanotechnology. The formation, mechanism, characteristics of titania nanotubes are explained and emerging critical role in tissue engineering and regenerative medicine is reviewed. The main focus of this paper is on the unique 3 dimensional tubular shaped nanostructure of titania and its effects on creating epochal impacts on cell behavior. Particularly, I discuss how different cells cultured on titania nanotube are adhered, proliferated, differentiated and showed phenotypic functionality compared to those cultured on flat titanium. As a matter of fact, the presence of titania nanotube surface structuring on titanium for dental applications had an important effect improving the proliferation and mineralization of osteoblasts in vitro, and enhancing the bone bonding strength with rabbit tibia over conventional titanium implants in vivo. The nano-features of titania nanotubular structure are expected to be advantageous in regulating many positive cell and tissue responses for various tissue engineering and regenerative medicine applications.