Healthcare-associated infection through transmission of pathogenic bacteria poses a huge threat to public health. One of the main transmission routes is via contaminated surfaces, including those of medical devices, and therefore significant efforts are being invested in developing new surface decontamination strategies. This includes visible light-based approaches, which offer improved compatibility with mammalian cells but lower germicidal efficacy with respect to UV-light. This study investigates the potential to enhance the antimicrobial efficacy of 405 nm light for surface decontamination through use of a photocatalytic TiO2-doped elastomer, elastomers being selected due to their wide use in biomaterials. Poly(dimethylsiloxane) (PDMS) was doped with TiO2 nanoparticles and the surface elastomer etched to expose the embedded nanoparticles. As etching results in increased surface roughness, samples with control nanoparticles (SiO2and Fe3O4) were also investigated to decouple the effects of roughness and photoinactivation upon bacterial attachment and inactivation. Characterisation by SEM, AFM and contact angle analysis confirmed that etching produced a rougher (39.3±15.3 vs 5.11±1.29 nm RMS roughness; etched vs unetched TiO2-PDMS), more hydrophobic surface (water contact angle of 120±2.5° vs 110±1.0°; etched TiO2-PDMS vs native PDMS). This surface, rich in exposed photocatalytic TiO2 nanoparticles, allows direct contact between contaminating bacteria and nanoparticles, enabling ROS generation in closer proximity to the bacteria and consequent enhancement of visible light treatment. Incorporating TiO2 into PDMS significantly improved the photoinactivation efficacy (mean bacterial count for light-treated samples normalised to untreated samples of 0.043±0.0081) compared to PDMS alone (0.19±0.036), when seeded with Staphylococcus aureus and exposed to 405 nm, 60 J cm-2 light. However, photoinactivation efficacy was significantly (p<0.001) enhanced by etching the TiO2-PDMS surface (0.015±0.0074), resulting in greater photoinactivation than that obtained for etched (47.0±14.5 nm RMS roughness), non-photocatalytic SiO2-PDMS (0.10±0.093). Results suggest this doping and etching strategy shows significant potential for facilitating decontamination of elastomer-based biomaterials.