In this study, the simultaneous significance of the crystallographic texture and nanostructuring on the cytocompatibility of as-cast (Ti55 Zr25 Nb10 Ta10 )98.5 -Ag1.5 alloy (at. %, TZNT-Ag1.5 ), subjected to cold rolling up to 90% reduction, along with the changes of Young's modulus and hardness under cold rolling were investigated. For this purpose, the as-cast and cold-rolled TZNT-Ag1.5 alloy test specimens were analyzed by XRD, TEM, HRTEM, SEM, contact angle, nanoindentation, and OM techniques. Moreover, to evaluate the effect of severe cold deformation on the biocompatibility, MG-63 osteoblastic cell was cultured on the surface of 90% cold-rolled and as-cast test specimens of TZNT-Ag1.5 alloy. The results showed that severe cold deformation was led to fast grain refinement of grains of the as-cast TZNT-Ag1.5 alloy in the range of 50-100 nm. In addition to the nanostructuring, upon severe cold deformation, the <gamma>-fiber (<111>// normal direction) texture was formed and after 90% reduction, the (111)<1 > γ-fiber component was strengthened. The micro-hardness and reduced Young's modulus are 235 ± 5.29, 246 ± 1.73, 271 ± 4.0, and 283 ± 6.25 (HV); and 73.725 ± 1.70, 83.98 ± 5.10, 81.26 ± 6.55, and 88.66 ± 7.16 (GPa) for TZNT-Ag1.5 (as-cast), TZNT-Ag1.5 (20%CR), TZNT-Ag1.5 (50%CR), and TZNT-Ag1.5 (90%CR) test specimens, respectively. Further, with increasing the cold deformation degree, the dislocation density of TZNT-Ag1.5 alloy increased as this parameter is 2.79 × 1015 (m-2 ) for the 90%CR test specimen. On the other hand, the values of the contact angle for the 90%CR test specimen (46.2 ± 3.5°) exhibit a higher hydrophilic and wettable surface as compared to the other studied test specimens. After 5 days of incubation, osteoblastic cells on the surface of the 90% cold-rolled TZNT-Ag1.5 test specimens revealed significant differences in cell proliferation and differentiation as compared to the as-cast alloy test specimens and/or CP-Ti. Finally, because the maximum orientation intensities were generally <3, it was deduced that grain refinement rather than the crystallographic texture plays a significant role in improving the surface biocompatibility of the new TZNT-Ag1.5 alloy.