Silicon(Si) and silver (Ag) co-doped amorphous carbon (a-C:H:Si:Ag) coatings were prepared by magnetron sputtering deposition. The results of Raman analyses revealed that the coating was dominated by sp2 carbon bonds and had graphite like structure. The a-C:H:Si:Ag coating exhibited a very high elastic recovery rate of 82%. Tribological tests in saline solution (NaCl, 0.9 wt%) showed that the average friction coefficient and the wear rate of the coating were as low as 0.016 and 1.2 × 10−8 mm3/(N·m), respectively. The dual doped coating exhibited a high antibacterial rate over 99% against Escherichia coli though containing a small content of Ag. It also was found that the silver ions release from the coating was extremely slow, and the newly developed (a-C:H:Si:Ag) coating would be a promising long term antibacterial materials.