Implant surgeries are increasingly challenging due to their rising number. Achieving the desired biomaterial surface properties to ensure a strong bond with human tissue is a significant issue. This study investigates the influence of ultrasound (US) during the micro-arc oxidation (MAO) process on Ti13Zr13Nb bio-alloy, an area not previously explored, to enhance titanium alloy coatings’ properties for biomedical applications. Porous calcium-phosphate-based coatings were successfully deposited on Ti13Zr13Nb using MAO and ultrasound micro-arc oxidation (UMAO). Various properties such as morphology, chemical composition, topography, wettability, surface free energy, thickness, adhesion to the substrate, as well as mechanical and corrosion characteristics were thoroughly analyzed. Cytocompatibility was assessed using human osteoblasts. Using US during the MAO process increased coating roughness (up to ~ 17%), core height (up to 22%), isotropy (up to 17%), thickness (up to ~ 46%), and hardness (up to ~ 18%), depending on MAO parameters and US mode. Optimal coating performance was achieved at 136 mA, 600 s, and a sinusoidal US setting, resulting in the highest isotropy (~ 79%) and rutile quantity (2.6%), the lowest elastic modulus (~ 57 GPa), and the contact angle of ~ 70°, all of which could have contributed to enhancing osteoblast viability in vitro. This study, for the first time, underscores the importance of using the US during the MAO in tailoring the Ti13Zr13Nb for specific biomedical applications.