Titanium alloys with light weight, high strength-to-weight ratio, and excellent corrosion resistance, are widely applied in the fields of marine, aerospace and medical instruments. However, titanium alloys are susceptible to adhesive wear, abrasive wear, and fretting wear due to their low harness and high friction coefficient, which greatly restricts their widespread use as friction parts. Micro-arc oxidation (MAO) treatment can give hard ceramic film with strong adhesion. MAO coatings can not only be used alone to improve the wear resistance of titanium alloys, but also be compatible with other post treatment methods. The effect of electrolytes, electrical parameters and different composite methods on the wear resistance of the MAO coatings is introduced in detail. Electrolytes play the most important role in the wear resistance of MAO coatings. If suitable electrolytes and additives are used for MAO treatment, the hard oxides of Al2O3, AlTiO5, SiO2 etc. can be mixed into the TiO2 film to greatly enhance the wear resistance. Adjustment of electrical parameters (including constant current/voltage, single/double output, frequency and so on) affects the types, contents, distribution, and roughness of the hard oxides in MAO coatings, which tremendously affect the friction and wear properties. Composite treatments include mechanical polishing, spraying graphite or PTFE, magnetron sputtering hard film, and addition of nanoparticles into the bath electrolytes. The addition of nanoparticles can repair the defects in the MAO coatings. Moreover, new oxide phases can be mixed into the MAO coatings to achieve the multifunctional properties of wear resistance, self-lubrication, and corrosion resistance. However, the dispersion, replenishment, and synergy effect of nanoparticles should be investigated further.