A detailed literature search was carried out to define the current knowledge about the biological performance of tantalum. The pure metal appears, to a great degree, to be inert both in vivo and in vitro. Both the pure metal and its principle oxide possess low solubility and toxicity; however, halide compounds are more biologically active. Local host response is benign, characterized by vital encapsulation in soft tissue and frequent osteointegration, reminiscent of titanium, in hard tissue. Tantalum has been in clinical use since before 1940 and has found a wide range of diagnostic and implant applications, with apparently overall excellent results. In some applications, such as for radiographic bone markers and cranial closure, tantalum may well be the current material of choice. In summary, metallic tantalum is a promising biomaterial whose applications have been limited by technical rather than biological performance considerations.