The utilization of porous biomedical implants featuring a bimodal microstructure has garnered substantial interest within the scientific community. This study delves into the intricate interplay between processing parameters, microstructural attributes, and the tribo-mechanical performance of titanium grade 4, showcasing its potential to serve as implants to address compromised cortical bone tissue. The investigation meticulously examines the impact of milling duration (10 and 20 h), proportion of milled powder (50 and 75 wt%), and the volume fraction of space-holding agents (40–60 vol% NaCl) on the resulting characteristics of the bimodal microstructure, which plays a crucial role in achieving optimal biomechanical equilibrium. The Vickers microhardness, conventional and instrumented (P-h curves), and the wear behavior (ball-on disk) are discussed in terms of bimodal microstructure distribution, particle size and porosity level inherent to the fabrication conditions (mechanical milling + space-holder + hot-pressing). In general terms, milling time and milled powder fraction were the most influent parameters on the final properties of the materials. With the processing route used, the achieved microhardness values and wear behavior are comparable with those obtained by means of surface modifications or alloys. The Young's moduli obtained were in the range of 30–50 GPa, which could help to reduce the shielding phenomenon, while presenting a good mechanical resistance and wear behavior. In light of these findings, the fabricated specimen, composed of 75 wt% milled powder subjected to a 10-h milling duration, supplemented by a 60 vol% fraction of NaCl, emerges as a prime candidate manifesting superior biomechanical equilibrium. This judicious configuration exhibits a promising trajectory for its application in bone replacement endeavors.