Abstract To explore the effects of surface morphology of titanium alloy on the proliferation characteristics of bone marrow mesenchymal stem cells (BMSCs), this investigation processed the Ti 6 Al 4 V with plane grinding (P), diamond shot peening (S1), diamond shot peening and acid etching (S2), 10–15 μm Al 2 O 3 blasting (S3), 10–15 μm Al 2 O 3 blasting and acid etching (S4) as well as 500–800 μm Al 2 O 3 blasting and acid etching (S5). The surface morphology, surface roughness, contact angle, and surface chemistry of samples were characterized. The number of cells was assessed by Cell Counting Kit-8, and the morphology of the cells was observed under a scanning electron microscope as well as fluorescence microscope. The results showed that the cells grew along the direction of the wear scar generated in the surface grinding process, which promoted the adhesion of the cells at the initial stage, but inhibited the proliferation of the cells at the later stage because of the abnormal stretching of the cells. In addition, the acid etching process stabilized the cell proliferation behavior by dissolving the alumina embedded in the surface after blasting with Al 2 O 3 powder. Highlights • The double etching process can dissolve the alumina embedded in the surface after blasting with Al 2 O 3 powder. • Proliferative stability of stem cell is directly related to the surface topography and surface free energy. • The diamond shot peening process reduces the alpha phase of the Ti alloy surface. [ABSTRACT FROM AUTHOR]