Titanium is widely used in implants but can cause adverse reactions like inflammation and tissue rejection. Surface modifications like acid-etching and anodization improve implant properties and osseointegration. This study investigated how micro and nanoporous TiO2 films affect the implant-host interaction, focusing on physical–chemical and biological aspects. Surface treated implants were obtained by acid-etched and anodization of commercially pure titanium (CPTi). Samples were characterized by FE- and FIB-SEM, XRD, EDX, WCA, profilometry, and electrochemical behavior was also investigated. Biocompatibility was accessed by protein adsorption (albumin and serum proteins), hemolysis, and in vitro fibroblast interaction. Anodic samples exhibited the highest corrosion resistance and apatite deposition. Protein adsorption was related to surface roughness and wettability. Samples followed the Langmuir model isotherm (Type I), except for galvanostatic samples (Type III isotherm). Kinetic adsorption was modeled by a pseudo-first-order model, wherein rate-limiting step is albumin diffusion into pores. All surfaces met the hemocompatibility requirements for its use as biomaterial (hemolysis index < 2 %). The upper surface roughness threshold was identified at approximately Sa ≈ 1 µm for better fibroblast viability, adhesion, and proliferation. Combining the results, nanoporous samples present optimized surface conditions that enhance body-fluid contact and improve cell adhesion, thereby contributing to long-term stability.