Multi-wall carbon nanotubes/hydroxyapatite (MWCNTs/HA) composites with 20%, 40% and 60% HA were successfully fabricated at 1200 degrees C and 120 MPa by spark plasma sintering (SPS). Scanning electron microscope (SEM) observations showed that MWCNTs/HA composites kept the nanostructure of MWCNTs after SPS treatment. The bulk density of the MWCNTs/HA composites was increased by the addition of HA. However, the Vickers hardness, porosity, Young's modulus, flexure strength and compression strength of the MWCNTs/HA composites were decreased with increasing content of HA. To test their biocompatibility, the MWCNTs/40% HA composites were inserted into rat femur. The in vivo reaction of four weeks showed that the composites possessed better osseointegration compared to pure MWCNTs. The results indicated that the MWCNTs/HA composites have potential for a wide variety of bonegraft applications in the future. (c) 2012 Elsevier B.V. All rights reserved.