Orthopedic and dental implants are commonly fabricated by titanium and its alloys. While these implants generally exhibit a high success rate, there are instances where they fail due to issues such as insufficient osseo-integration, bone resorption, and postoperative infections. In light of these challenges, localized drug delivery through implants is a promising approach. It offers advantage of delivering medications directly to the target area while managing potential side effects associated with systemic drug administration. To achieve drug release from titanium implants, surface modification techniques involving coating or adsorption have been developed. Currently, there are two main methods being employed. The first method involves modifying the implant's surface or pore structure by incorporating a drug-loaded carrier made of polymers, ceramics, or composites. This carrier acts as a reservoir for the medication and releases it gradually over time. Alternatively, drugs can be directly injected into the implant material itself. The primary focus of research in this field revolves around achieving controlled medication release and ensuring adsorbed or coated materials stability physical and mechanically. These aspects are critical to ensure the effectiveness and longevity of the drug delivery system. Recent advancements in both methods have set the stage for titanium implants development with multiple functionalities, specifically designed for targeted medication administration. In summary, titanium implants are widely used in implants, but complications can arise, leading to failure. Localized drug delivery through surface modification or direct drug injection into the implant material has gained significant attention. Ongoing research aims to enhance the control of drug release and optimize the stability of the coating or adsorbed materials. This review highlights the latest developments in these methods, contributing to the advancement of titanium implants with enhanced capabilities for targeted medication delivery.