When used as an implanted material, titanium (Ti) surface controls the subsequent biological reactions and leads to tissue integration. Cells interactions with the surface, through a protein layer that is being formed from the moment Ti surface comes in contact with blood and its components, and indeed this protein layer formation, are regulated by surface properties such as topography, chemistry, charge and surface energy. Currently, the implementation of nanotechnology, in an attempt to support mimicking the natural features of extracellular matrix, has provided novel approaches for understanding and translating surface mechanisms whose modification and tailoring are expected to lead to enhanced cell activity and improved integration. Despite the fact that there has been extensive research on this subject, the sequence of interactions that take place instantly after the exposure of the implanted material into the biologic microenvironment are not well documented and need further investigation as well as the optimization of characteristics of Ti surface. This review, including theoretical and experimental studies, summarizes some of the latest advances on the Ti surface concerning modifications on surface properties and how these modifications affect biomolecular reactions and also attempts to present the initial adsorption mechanism of water and protein molecules to the surface.