A biomedical beta-type Ti-13Nb-13Zr (TNZ) (wt pct) ternary alloy was subjected to severe plastic deformation by means of hydrostatic extrusion (HE) at room temperature without intermediate annealing. Its effect on microstructure, mechanical properties, phase transformations, and texture was investigated by light and electron microscopy, mechanical tests (Vickers microhardness and tensile tests), and XRD analysis. Microstructural investigations by light microscope and transmission electron microscope showed that, after HE, significant grain refinement took place, also reaching high dislocation densities. Increases in strength up to 50 pct occurred, although the elongation to fracture left after HE was almost 9 pct. Furthermore, Young's modulus of HE-processed samples showed slightly lower values than the initial state due to texture. Such mechanical properties combined with lower Young's modulus are favorable for medical applications. Phase transformation analyses demonstrated that both initial and extruded samples consist of alpha' and beta phases but that the phase fraction of alpha' was slightly higher after two stages of HE. (C) The Author(s) 2017.