Tissue engineering utilizes the expertise in the fields of materials science, biology, chemistry, transplantation medicine, and engineering to design materials that can temporarily serve in a structural and/or functional capacity during regeneration of a defect. Hydroxyapatite (HAp) scaffolds are among the most extensively studied materials for this application. However, HAps have been reported to be too weak to treat such defects and, therefore, have been limited to non-load-bearing applications. Recent advancements in nanoscience and nanotechnology have reignited investigation of HAp formation in the nanorange to clearly define small-scale properties of HAp. It has been suggested that nano- HAp may be an ideal biomaterial due to its good biocompatibility and bone integration ability. In this chapter, a new view on nano-HAp particles highlights the importance of size, crystal morphology controls, and composites with other inorganic particles in the application of biomedical material development. We have also reviewed nanosized HAp-based highly porous composite materials used for bone tissue engineering, introduced various fabrication methods used to prepare nHAp/polymer composite scaffolds, and characterized these scaffolds on the basis of their biodegradability and biocompatibility through in vitro or in vivo tests. Finally, we provide a summary and our own perspectives on this active area of research.