Bioactivity is a property of the ceramic surface which induces biological integration of living soft and hard tissues. The core mechanism of bioactivity is surface biomineralization of calcium phosphate nanocrystallites on ceramics with specific compositions and structures, inspiring acellular and cellular strategies for bio-interactive materials with new physical, chemical and biological functions. These include bioactive surface functionalizations on metallic, ceramic and polymeric substrata for biomedical materials with different mechanical properties, bioactive ceramic-polymer nanohybrids for soft tissue replacements and engineering, template-textured depositions of biomimetic nano-calcium phosphate for hybridization of bio-macromolecular and cellular functions, concerning which this paper reviews with in vivo and in vitro fundamentals and perspectives in tissue engineering.