A new fabrication process of a stem for an artificial hip joint has been investigated to improve mechanical properties and to reduce both the fabrication cost and consumption of expensive Ti alloys by swaging and die-forging into near-net-shape at room temperature, followed by local heat treatment and precise machining. In this study metastable β Ti-Nb-Sn alloys consisting of non-cytotoxic elements (biocompatible Ti alloys) were used for biomedical applications. It is found that swaging at both ends of a rod before die-forging saves material consumption by approximately 50% in comparison with turning, and enhances subsequent age-hardening. In addition the cold die-forging enables the fabrication costs to decrease. It is suggested that high strength of higher than 1100 MPa in the proximal part connected to a stem head and low Young's modulus of less than 60 GPa in the distal part implanted in a femur can be obtained simultaneously in advanced Ti alloy stems.