This paper reviews different approaches to obtain biomaterials with tailored functionalities and explains their significant characteristics that influence their bioactivity. The main goal of this discussion underscores the significance of surface properties in materials, with a particular emphasis on their role in facilitating cell adhesion in order to obtain good biocompatibility and biointegration, while preventing adverse effects, such as bacterial contamination and inflammation processes. Consequently, it is essential to design strategies and interventions that avoid bacterial infections, reducing inflammation and enhancing compatibility systems. Within this review, we elucidate the most prevalent techniques employed for surface modification, notably emphasizing surface chemical composition and coatings. In the case of surface chemical composition, we delve into four commonly applied approaches: hydrolysis, aminolysis, oxidation, and plasma treatment. On the other hand, coatings can be categorized based on their material composition, encompassing ceramic-based and polymer-based coatings. Both types of coatings have demonstrated efficacy in preventing bacterial contamination, promoting cell adhesion and improving biological properties of the surface. Furthermore, the addition of biological agents such as drugs, proteins, peptides, metallic ions plays a pivotal role in manifesting the prevention of bacterial infection, inflammatory responses, and coagulation mechanism.