Ion beam irradiation of solid surfaces may result in the self-organized formation of well-defined topographic nanopatterns. Depending on the irradiation conditions and the material properties, isotropic or anisotropic patterns of differently shaped features may be obtained. Most intriguingly, the periodicities of these patterns can be adjusted in the range between less than twenty and several hundred nanometers, which covers the dimensions of many cellular and extracellular features. However, even though ion beam nanopatterning has been studied for several decades and is nowadays widely employed in the fabrication of functional surfaces, it has found its way into the biomaterials field only recently. This review provides a brief overview of the basics of ion beam nanopatterning, emphasizes aspects of particular relevance for biomaterials applications, and summarizes a number of recent studies that investigated the effects of such nanopatterned surfaces on the adsorption of biomolecules and the response of adhering cells. Finally, promising future directions and potential translational challenges are identified.