Plasma polymerization has evolved in an important technology for generation of thin films that have found numerous advanced applications. The orthodox view to plasma polymers is as continuous, homogeneous and pinhole-free coatings. However, there is an emerging trend towards creating more advanced films though engineering them at the nanoscale. This paper presents a summary of our work and published studies, from other groups, which demonstrate the potential of plasma polymerization to generate advanced nanostructured interfaces. The focus is on applications in the area of biomaterials. Strategies for generation of antibacterial coatings through inclusion of metallic nanoparticles in plasma polymer films are described. Drug delivery platforms developed via templating and incorporation of drug particles are outlined. A record of recent progress in fabrication of cell guidance surfaces facilitated by nanoengineering of plasma polymer film is also included. The paper concludes with the author's view to the future outlook of the niche area of nanoengineered plasma polymer films.