Plasma-sprayed hydroxyapatite (HA) coatings were incubated in simulated body fluids (SBFs) for different periods of time to investigate the nucleation and growth of apatite on their surface. The layer that formed was recognized as having similarities to bone apatite because it is poorly crystallized, non-stoichiometric or calcium deficient, and contains carbonate and magnesium. Scanning electron microscopy (SEM) and infrared spectroscopy (IR) were employed to investigate the morphological changes of the coating surface and the structure of the grown layer respectively. In the first few hours, calcium and phosphate ions dissolved from the coatings so as to increase their local supersaturation to a higher degree, thereafter followed by the nucleation and growth of apatite. The nucleation occurred firstly on the recessed regions, inside pores and cracks where the higher supersaturation was readily maintained. Only after 24 h incubation was a complete layer formed on the surface of the coating. There is no obvious interface between the grown layer and the underlying coating. Heat treatment in the air made the apatite transform into biphasic calcium phosphate of HA and tricalcium phosphate, with a blue colour because of trace manganese ions. The heat-treated HA coating showed no dissolution by SEM observation. This resulted in no precipitation on the surface. When SBF was used with two-fold higher ion concentrations, the apatite layer formed slowly in 72 h without dissolution of the coating surface. This may mean that the microenvironment with a sufficiently high degree of supersaturation of calcium and phosphate ions is crucial for apatite to nucleate and grow in SBF, while the HA crystalline structure is not critical in the nucleation process, as expected.