Several polymeric materials find application in biomedical implants and devices due to their superior physicochemical properties. The main requirement for these polymers is that they should be biocompatible, which means they prevent bacterial adhesion and are blood compatible. Many parameters contribute to the degree of biocompatibility. This paper discusses the mechanism of the formation of biofilms and lists the factors that influence the bacterial adhesion and haemocompatibility. Polymer surfaces are also modified to enhance adsorption of host cells. The physical, chemical and biological techniques are meant to modify the surface of the biomaterial but at the same time retain the key properties. The various polymer treatment processes have advantages and disadvantages and a few techniques have been proved to be both highly effective at treatment and found suitable for various in vivo environments. The current research focus pertaining to smart materials, biodegradable polymers, combinatorial chemistry, computational modelling and newer analytical techniques to understand polymer-cell interaction holds promise in designing better, cost effective and biocompatible polymers. © 2008 IOP Publishing Ltd.