Fatigue properties of the Al2O3 plasma-sprayed SUS316L stainless steel rod specimens coated on different spraying conditions have been studied in a physiological saline solution (0.9 % NaCl solution) to evaluate the potential of surgical implant application. Fatigue tests were conducted in push-pull loading at the stress ratio of R = -1, and frequency of 2 Hz. Microstructure related with fatigue damage was examined by SEM and TEM. The fatigue strength of Al2O3 plasma-sprayed metals significantly depended on spraying conditions: the effects of spraying on fatigue strength decreased with increasing the applied stress amplitude. As-blasted specimens were higher in fatigue strength than Al2O3 plasma-sprayed specimens. It was found that the plasma spraying had significant effects on fatigue crack growth behavior in the early stage of crack propagation. Fatigue cracks preferentially originated from dents that had been caused on the substrata metal surface subjected to grit-blasting. These results are discussed with both the compressive residual stresses due to the grit blasting which was carried out prior to plasma spraying and the corrosion-resistance of the alumina deposit.