beta-Type titanium alloys are promising materials for orthopaedic implants due to their relatively low Young's modulus and excellent biocompatibility. However, their strength is lower than those of alpha- or alpha + beta-type titanium alloys. Grain refinement by severe plastic deformation (SPD) techniques provides a unique opportunity to enhance mechanical properties to prolong the lifetime of orthopaedic implants without changing their chemical composition. In this study, beta-type Ti-45Nb (wt%) biomedical alloy in the form of 30 mm rod was subjected to hydrostatic extrusion (HE) to refine the microstructure and improve its mechanical properties. HE processing was carried out at room temperature without intermediate annealing in a multi-step process, up to an accumulative true strain of 3.5. Significant microstructure refinement from a coarse-grained region to an ultrafine-grained one was observed by optical and transmission electron microscopy. Vickers hardness measurements (HV0.2) demonstrated that the strength of the alloy increased from about 150 to 210 HV0.2. Nevertheless, the measurements of Young's modulus by nanoindentation showed no significant changes. This finding is substantiated by X-ray diffraction analyses which did not exhibit any phase transformation out of the bcc phase being present still before processing by HE. These results thus indicate that HE is a promising SPD method to obtain significant grain refinement and enhance strength of beta-type Ti-45Nb alloy without changing its low Young's modulus, being one prerequisite for biomedical application.