Strontium-doped hydroxyapatite (Ca9Sr1(PO4)6(OH)2, Sr1-HA) nanorods with different lateral spacing (e.g., interrod spacing) values (67.3 ± 3.8, 95.7 ± 4.2, and 136.8 ± 8.7 nm) and nanogranulates were grown on microarc-oxidized microporous TiO2, respectively, to form multilayer coatings. The coatings reveal two kinds of micro/nanoscaled hierarchical surfaces with a similar microscale roughness, e.g., nanogranulated 2D pattern and nanorod-shaped 3D pattern in nanotopography. When hFOB1.19 cells are employed, the proliferation and differentiation of osteoblasts on the coatings were evaluated by examining MTT assay, expressions of osteogenesis-related genes [alkaline phosphatase (ALP), runt-related transcription factor 2, osterix, osteopontin (OPN), osteocalcin (OCN), and collagen I (Col-I)], ALP activity, contents of intracellular Ca(2+), Col-I, OPN, and OCN, extracellular collagen secretion, and extracellular matrix mineralization. The results reveal that the proliferation and differentiation of osteoblasts can be directly regulated by the interrod spacing of the Sr1-HA nanorods, which are significantly enhanced on the nanorod-shaped 3D patterns with interrod spacing smaller than 96 nm and more pronounced with decreasing the interrod spacing but inhibited on the nanorods with spacing larger than 96 nm compared to the nanogranulated 2D pattern. The difference in the cellular activity is found to be related with the intracellular Ca(2+) concentrations, which are regulated by variation of the surface topology of Sr1-HA crystals. Our work provides insight to the surface structural design of a biomedical implant favoring osteointegration.