Tantalum (Ta) is a refractory metal widely used in biomedicine as a bone substitute, mainly due to its suitable mechanical properties such as fatigue strength and corrosion resistance. Besides being biocompatible and well accepted by the body, Ta also has osteoconductive and osteoinductive properties. In addition, the structural design through the production of porous implants makes the material better adapted to the needs of bone tissue. In this chapter, we describe the properties of Ta-based materials, the relevance of using Ta porous structures for medical applications, and the existing manufacturing processes to produce them. An extensive review of the most important studies related to surface modification has been done, including Ta as a coating or as a substrate. As the Trabecular Metal technology has been widely used in the Ta implantology, an extensive description of the most relevant clinical studies with such porous Ta is included.