Magnesium-based composites with bioactive ceramic particles addition are promising materials for biomedical implant applications. Nevertheless, the agglomeration of bioactive ceramic particles remains a challenge for fabricating high-performance biomedical magnesium-based composites. Herein, a novel high-performance biomedical rare-earth magnesium alloy-based WE43/hydroxyapatite (HA) composite is successfully fabricated via multi-pass friction stir processing (MP-FSP). Systematic investigations reveal that MP-FSP leads to a uniform distribution of HA particles and efficient elimination of defects. The microstructural analysis shows a significant grain refinement in the WE43 alloy from 49.4 μm to 2.4 μm under triple-passes FSP. The mechanical properties of the composite are enhanced significantly under triple-passes FSP, with yield strength, ultimate tensile strength, and elongation reaching 236.2 MPa, 278.6 MPa, and 14.2% respectively. Corrosion resistance is also improved, with a 30% reduction in the corrosion rate in SBF solution compared to the unprocessed alloy. Moreover, the MP-FSP fabricated composites exhibit superior corrosion-wear resistance, characterized by slight abrasive wear compared to the abrasive wear and severe pitting corrosion observed in the base WE43 alloy. These improvements are attributed to the synergistic effects of grain refinement, dispersion strengthening, enhanced interfacial bonding, and texture modification. Overall, these findings provide significant quantitative insights into the advanced fabrication techniques of magnesium-based composites for biomedical implant applications, highlighting the effectiveness of MP-FSP in enhancing both mechanical and corrosion-related properties.