The surface microtopography and physical-chemical results of Ti6Al4V alloy were investigated in relation to bone cell response. Nd:YAG-laser-treated surfaces with (1.06 mu m wavelength, 200 mu s pulse duration, and a fluence of 140 Jcm(-2) exhibited an improved hydrophilic behavior due to a lower contact angle compared with the control sample. Cell spreading on the implanted specimens was analyzed by scanning electron microscope (SEM), and their condition in a specific area was studied for 10 cells from three separate regions on the same specimen using an Image J Program software. The in vitro the in vivo tests provided some useful clinical and pathological information such as the number of adhered cells on the implant. The light microscopy assessment consisted of a complete morphological description of tissue response to the implants with different surface topography.