Introducing micro- and nanoscale features on biomaterials in an engineered, controlled manner has been shown to positively affect medical implant integration into the human body. A key factor in this process is the initial cellular response toward the implant. Different techniques such as chemical treatment, plasma spraying, lithography, and coatings, among others, have been applied during the last decades to improve the implant integration. One of the methods that started to be recently exploited is laser surface engineering (LSE). LSE offers a wide range of new surface engineering methods, such as laser surface melting (LSM), laser engineered net shaping (LENS), and selective laser melting/sintering (SLM/S) that can generate complex micro- and nanoscale features with high resolution. This review provides an overview of the initial cellular response to medical implants and the different techniques used to modify the surface of different biomaterials. An emphasis is given to laser techniques that were recently developed for surface texturing, describing in vitro, pre-clinical, and clinical trials performed thus far.