Abstract: Titanium and its alloys are the predominant base materials for oral implants. However, challenges such as prolonged osseointegration periods and limited success rates persist due to their inherent low surface bioactivity. Femtosecond laser processing has emerged as an innovative, non-thermal, and high-precision surface modification technique, offering a novel approach to precisely tailor the micro-nano topography, chemical composition, and biological performance of implant surfaces. This review summarizes research advances in femtosecond laser surface treatment of titanium implants over the past five years. It systematically elaborates on methods for constructing specific surface architectures by regulating parameters such as laser power, wavelength, scanning strategies, and pulse patterns. Furthermore, it introduces hybrid processing strategies that combine femtosecond laser with techniques like hydroxyapatite deposition, sandblasting, and 3D printing, highlighting their synergistic effects. By comparing femtosecond laser processing with conventional surface treatment technologies (e.g., sandblasting and acid etching, electrochemical deposition, plasma sputtering), this paper analyzes its unique advantages in terms of processing precision, heat-affected zone, biocompatibility, and long-term stability. Finally, current challenges (e.g., equipment cost, processing efficiency) are summarized, and future development directions are proposed, including personalized implant manufacturing, multifunctional surface construction, and integration with other advanced technologies.