Using surface cues to guide and ultimately control cellular responses is of paramount importance in numerous biomedical applications. Since cells react on feature sizes both on the micro and nanometer scale, these length scales are crucial parameters when designing new materials for applications in medicine e.g. for tissue engineering and drug delivery. Thus, variation of the features at the nanometer length scale is an integral part of nanomedicine research and development. In this chapter the interaction between biological systems and artifi cial materials will be addressed in general with focus on simplifi ed model systems where only one or a few parameters are varied at two-dimensional (2D) surfaces. At fi rst biomolecular adsorption/immobilization on surfaces will be addressed followed by a discussion of approaches to synthesize functionalized surfaces and the infl uence of such surfaces on cellular response. Some of the key parameters, which will be discussed in more detail, are topography, chemistry, and elastic modulus of the substrate. Even though there is a vast amount of published data it will become clear that there is still not a detailed understanding of the infl uence of these parameters on biosystems at the cellular level. Obviously, the degree of complexity increases when several of the surface cues are combined. The challenges in understanding the cellular responses in detail in real systems with the simultaneous variation of multiple parameters leads to the introduction of the fi eld of high throughput screening of biomaterials.