Oxygen plasma treatment and/or cellulase enzyme treatment was carried to improve the surface properties of cotton fabrics for medical applications. The influence of Plasma (P), enzyme (E), plasma preceded by enzyme (EP) and enzyme preceded by plasma (PE) treatments on hydrophilicity of the cotton fabrics was studied using standard wicking test. The physical and chemical modification due to plasma and enzymatic treatments were analyzed using SEM and ATR-FTIR spectroscopy. The FTIR results revealed that the oxygen plasma has modified the surface chemically by introducing oxygen containing groups (C=O, C-O, COO -) onto the fabric surface and enzyme have hydrolyzed the cellulose molecule. The physical etching of the fabric surface was observed in SEM photographs and weight loss measurements. The modified fabrics were given antimicrobial finish and tested for its antimicrobial activity against S.aureus and E.coli using AATCC 100 test. The EP treated fabric was found to have 100% bacterial reduction. The wash durability of the finished fabrics was also assessed and the results are discussed.