Based on a high power CO2 laser beam passing by pyramid polygon mirror, the bioceramic coatings of gradient composition were fabricated on titanium alloy substrate (Ti-6Al-4V). The relations among laser processing parameters, microstructure and biocompatibility of the gradient bioceramic coatings were investigated. The results indicated that the contents of rare earth oxide additions had an immediate effect on the formation of bioactive phases. The gradient bioceramic coatings showed favorable biocompatibility in vivo after they were implanted into canine femur for 45, 90, and 180 days, respectively. The bioceramic coatings of Ca/P=1.4 and 0.6wt.% Y2O3 totally combined with new bones merely implanted for 45 days. Furthermore, the MTT (Methyl Thiazolyl Tetrazolium) colorimetry results of cell proliferation demonstrated that the cell growth distinctly increased on the gradient bioceramic coatings by laser cladding compared with the un-treated titanium alloy substrate.