Since hydroxyapatite (HAp) is an important constituent of bone and teeth, it has excellent biocompatibility and bioactivity, good osteoconductive effects and the ability to induce bone formation as a material for bone or tooth repair and replacement. At present, widely used HAp microspheres have some characteristics, such as large specific surface area, light mass, good injection properties, good fluidity, and low aggregation ability, but they are difficult to really meet the biological and clinical needs due to their own mechanical property defects, such as low strength, brittleness, and poor plasticity. Based on the current research status of HAp microspheres, we summarize the research progress of various types of composite microspheres, including inorganic materials, natural polymer materials and synthetic polymer materials, and further analyze the advantages of HAp composite microspheres loaded with drug molecules, proteins and bioactive factors, so as to explore the development prospect of HAp composite microspheres as scaffolds for constructing sustained release systems. It provides a theoretical basis and research direction to prepare HAp composite micro-spheres with superior comprehensive properties so that they can be better applied in bone tissue regeneration and tooth regeneration engineering.