• Calcium sulfate-magnesium oxide composites exhibit enhanced antibacterial activity against both Escherichia coli and Staphylococcus aureus, with efficacy increasing proportionally to magnesium oxide content.
• The composites maintain good cytocompatibility, particularly at lower magnesium oxide ratios (2.5% and 7.5%), supporting MC3T3 cell viability and proliferation.
• CS-2.5MgO significantly enhances osteogenic differentiation and mineralization, as evidenced by increased alkaline phosphatase activity, alizarin red staining, and RUNX2/WNT3a expression.
• CS-7.5MgO demonstrates the strongest pro-angiogenic effect, promoting tube formation in HUVECs and upregulating endothelial nitric oxide synthase expression.