Literature contains very few data about the potential biomedical application of amorphous hydrogenated carbon (a-C:H) thin films deposited by reactive pulsed magnetron discharge even so it is one of the most scalable plasma deposition technique. In this article, we show that such a C2H2 pulsed magnetron plasma produces high quality coating with good hemocompatibility and bioactive response: no effect on hemolysis and hemostasis were observed, and proliferation of various cell types such as endothelial, fibroblast, and osteoblast-like cells was not affected when the deposition conditions were varied. Cell growth on a-C:H coatings is proposed to take place by a two-step process: the initial cell contact is affected by the smooth topography of the a-C:H coatings, whereas the polymeric-like structure, together with a moderate hydrophilicity and a high hydrogen content, directs the posterior cell spreading while preserving the hemocompatible behavior.