Nanostructured WC-Co coatings were synthesized using high velocity oxygen fuel (HVOF) thermal spray. The nanocrystalline feedstock powder with a nominal composition of WC-18 wt.%Co was prepared using the novel integrated mechanical and thermal activation (IMTA) process. The effects of HVOF thermal spray conditions and powder characteristics on the microstructure and mechanical properties of the as-sprayed WC-Co coatings were studied. It was found that the ratio of oxygen-to-hydrogen flow rate (ROHFR) and the starting powder microstructures had strong effects on decarburization of the nano-coatings. Decarburization was significantly suppressed at low ROHFR and with the presence of free carbon in the powder. The level of porosity in the coatings was correlated with the powder microstructure and spray process conditions. The coating sprayed at ROHFR=0.5 exhibited the highest microhardness value (HV300g=1077), which is comparable to that of conventional coarse-grained coatings.