Abstract: The preparation of functional surfaces is one of the important methods to enhance the therapeutic performance and safety of medical devices. Currently, the fabrication of functional surface microstructures based on laser processing is widely used in the optimization of medical device surface properties. This paper reviews the current research status of functional microstructures for laser processing of medical implantable and surgical devices in terms of cell function regulation, antimicrobial properties, corrosion resistance, frictional properties, and anti-adhesion, etc. It analyzes the advantages and limitations of laser processing of functional surfaces for medical devices and outlooks the development prospects of laser processing technology for functional surfaces for medical devices.