Titanium and titanium alloys are widely used in biomedical devices and components, especially as hard tissue replacements as well as in cardiac and cardiovascular applications, because of their desirable properties, such as relatively low modulus, good fatigue strength, formability, machinability, corrosion resistance, and biocompatibility. However, titanium and its alloys cannot meet all of the clinical requirements. Therefore, in order to improve the biological, chemical, and mechanical properties, surface modification is often performed. This article reviews the various surface modification technologies pertaining to titanium and titanium alloys including mechanical treatment, thermal spraying, sol-gel, chemical and electrochemical treatment, and ion implantation from the perspective of biomedical engineering. Recent work has shown that the wear resistance, corrosion resistance, and biological properties of titanium and titanium alloys can be improved selectively using the appropriate surface treatment techniques while the desirable bulk attributes of the materials are retained. The proper surface treatment expands the use of titanium and titanium alloys in the biomedical fields. Some of the recent applications are also discussed in this paper.