In the present study, we evaluated the effects of high pressure torsion (HPT) and subsequent short time annealing processing on fatigue properties and cytocompatibility of the biomedical CoCrMo alloy (CCM). Before processing, CCM was solution treated (CCM ST) to achieve a microstructure composed of coarse single £-phase equiaxed grains with no internal strain. Through HPT processing, an inhomogeneous microstructure containing both micro-and nano-scaled grains is obtained in CCM specimens, which were named as CCM HPT , accompanied by high internal strain and extensive ¾ martensite. Following a subsequent short time annealing, a uniform single £-phase ultrafine-grained microstructure with small local strain fields dispersed forms in CCM specimens, which were named as CCM HPTA. This microstructure change improves fatigue strength in CCM HPT , and further in CCM HPTA , because of the enhanced crack initiation and/or propagation resistance. For cytocompatibility evaluation, the cells cultured on CCM ST show an immobilization tendency, while those cultured on CCM HPT exhibit a locomotion tendency. The cells cultured on CCM HPTA have an intermediate pattern. Compared with CCM ST , much larger numbers of cells are proliferated in both CCM HPT and CCM HPTA. All these results demonstrate that the CCM HPTA offers an improved fatigue property and a good cytocompatibility. Therefore, it is promising for use in biomedical applications.