The convergence of metal 3D printing and advanced surface engineering offers a transformative approach to tissue engineering, particularly in orthopedic and dental applications. This chapter explores the development of metallic 3D-printed scaffolds enhanced with functional coatings to address biocompatibility, antibacterial resistance, and mechanical robustness. We discuss state-of-the-art techniques in additive manufacturing, surface functionalization strategies, and their synergistic role in promoting tissue regeneration. By integrating bioactive and antibacterial features, these scaffolds provide a sustainable solution for complex tissue engineering challenges, paving the way for next-generation regenerative medicine.