In the present work, activated-carbon-containing pellets were preparedby direct chemical activation of sawdust, using clays as a binder. The obtained pellets (ACC) were coated with hydroxyapatite (HAp) nanoparticles (ACC-HAp) to improve adsorption towards Pb(II), Cu(II), Zn(II), and Ni(II). The pellets were characterized by scanning electron microscopy (SEM), by Fourier transform infrared spectroscopy (FTIR), and with a gas sorptometer. The effect of pH, contact time, and initial concentration on adsorption performance was investigated. Additionally, desorption studies were performed, and the regeneration influence on compressive strength and repeated Pb(II) adsorption was investigated. The results showed that, after coating ACC pellets with HAp nanoparticles, the adsorption capacity increased for all applied heavy metal ions. Pb(II) was adsorbed the most, and the best results were achieved at pH 6. The adsorption process followed the pseudo-second-order kinetic model. The adsorption isotherm of Pb(II) is better fitted to the Langmuir model, showing the maximum adsorption capacity of 56 and 47 mg/g by ACC-HAp and ACC pellets, respectively. The desorption efficiency of Pb(II)-loaded ACC-HAp pellets increased by lowering the pH of the acid, resulting in the dissolution of the HAp coating. The best desorption results were achieved with HCl at pH 1 and 1.5. Therefore, the regeneration procedure consisted of desorption, rinsing with distilled water, and re-coating with HAp nanoparticles. After the regeneration process, the Pb(II) adsorption was not affected. However, the desorption stage within the regeneration process decreased the compressive strength of the pellets.