The aim of this work is to provide a new kind of polyurethane with improved surface blood compatibility for long-term blood-contacting biomaterials. In the study, an aliphatic poly(ester-urethane) (H-PEU) with uniform-size hard segments was synthesized by one-step chain extension of poly(ε-caprolactone) (PCL) with diurethane diisocyanate (HBH), and biomimetic phosphorylcholine (PC) groups were immobilized onto the film surface with high grafting efficiency by three-step chemical treatments under mild reaction conditions. The H-PEU film was firstly treated with 1,6-hexanediisocyanate (HDI) to introduce -NCO groups on the surface (H-PEU-NCO) through an allophanate reaction; the -NCO groups were then coupled via a condensation reaction with one of -NH2 groups of tris(2-aminoethyl)amine (TAEA) to immobilize -NH2 on the surface (H-PEU-NH2); finally, the double bond of 2-methacryloyloxyethyl phosphorylcholine (MPC) reacted with -NH2 by Michael addition reaction to obtain MPC-grafted H-PEU (H-PEU-MPC). The modified surfaces were characterized by Fourier transform infrared spectroscopy (FT-IR) and X-ray photoelectron spectroscopy (XPS). The results verified that MPC was successfully grafted onto H-PEU surface with high grafting density. The blank and modified films showed similar crystallization behaviors, thermal stabilities and mechanical properties, indicating that the chemical treatments had minimum influence on the physicochemical properties of the substrate. The H-PEU-MPC displaying a much lower water contact angle (~15.2°) than H-PEU (80.3°) meant that the hydrophilic PC functional groups improved the surface hydrophilicity significantly. The surface blood compatibility was examined by bovine serum albumin adsorption and platelet adhesion tests, and the results revealed that H-PEU-MPC had improved resistance to protein adsorption and platelet adhesion capacity. The MPC-grafted H-PEU film possessed outstanding mechanical properties (ultimate stress: 36.1 MPa; strain at break: 883%), low protein adsorption quantity (1.33 μg/cm2) and good anti-platelet adhesion capacity (582 ± 16 per mm2), implying its high potential to be applied as biomaterials for vascular grafts, subcutaneously implanted devices or other blood-contacting devices.