This systematic review evaluates the role of carbonate apatite (CO3Ap) in bone reconstructive surgery and tissue engineering. CO3Ap has gained popularity due to its excellent tissue behavior and osteoconductive potential. The review analyzes its advantages, limitations, and potential applications, including bone substitution, scaffolding, implant coating, drug delivery, and tissue engineering. CO3Ap is shown to have superior biocompatibility, resorbability, and osteoconductivity compared to hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP). It promotes bone formation and new bone maturation, with minimal immunological reactions. However, it has limitations such as poor mechanical properties and high solubility. Further research is needed to optimize its fabrication and evaluate its safety and efficacy in clinical trials. CO3Ap shows promise as a promising bone substitute material and a potential biomimetic material in bone reconstructive surgery.This systematic review evaluates the role of carbonate apatite (CO3Ap) in bone reconstructive surgery and tissue engineering. CO3Ap has gained popularity due to its excellent tissue behavior and osteoconductive potential. The review analyzes its advantages, limitations, and potential applications, including bone substitution, scaffolding, implant coating, drug delivery, and tissue engineering. CO3Ap is shown to have superior biocompatibility, resorbability, and osteoconductivity compared to hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP). It promotes bone formation and new bone maturation, with minimal immunological reactions. However, it has limitations such as poor mechanical properties and high solubility. Further research is needed to optimize its fabrication and evaluate its safety and efficacy in clinical trials. CO3Ap shows promise as a promising bone substitute material and a potential biomimetic material in bone reconstructive surgery.