To investigate the feasibility of high-entropy alloys as the coating materials for the application of bone implants, TiZrNbTa refractory medium-entropy alloy (RMEA) and TiZrHfNbTa refractory high-entropy alloy (RHEA) nanofilms were prepared on AISI 316L stainless steel by DC magnetron sputtering and post-annealing treatment. Then, the microstructure, mechanical properties, wear resistance, corrosion resistance, biocompatibility and osteogenic activity of the nanofilms were systematically studied. The results showed that both the films exhibited uniform and dense nanostructures. Post-annealing treatment not only improved the adhesion strength, but also formed an oxidized layer. Notably, owing to the enhanced high-entropy and lattice distortion effects, the RHEA nanofilm showed finer grain sizes, higher hardness (14 GPa), H/E, H3/E2 and better wear resistance. The in vitro experiments proved that RHEA nanofilm had the highest Ecorr (−0.127 V), with the Icorr value was two orders of magnitude lower than substrate. Its osteoblast proliferative capacity was 1.5 times higher than substrate (after culturing for 5 days), and the collagen secretion and extracellular matrix mineralization reached an optimal level, showing excellent osteogenic activity. Therefore, RHEA nanofilm coated biomaterials can be a more attractive candidate for bone replacement.