Zirconia (ZrO2) is a hard and brittle dental implant material without anti-infective property. This work reports the preparation of a tertiary micro-nano hierarchical structure on a ZrO2 surface via femtosecond laser texturing combined with magnetron sputtering deposition of an Ag layer (Ag/ZrO2), aiming to achieve a superhydrophobic synergistic antibacterial effect. Laser-scanning pitch and Ag layer thickness were systematically optimized for obtaining the tertiary hierarchical structure. The wettabilities, antibacterial properties and durabilities of various ZrO2 and stearic acid modified Ag/ZrO2 (S-Ag/ZrO2) surfaces were further tested and comparatively analyzed. The results revealed that the optimal process parameters were a laser-scanning pitch of 30 μm and an Ag layer thickness of 100 nm. The as-obtained S-Ag/ZrO2 sample displayed a tertiary micro-nano hierarchical structure, which was featured by a periodic regular conical micro-convex structure covered with ZrO2 nano-protrusions and Ag nanoparticles. This structure could not only greatly reduce the solid-liquid contact area to achieve outstanding superhydrophobicity and durability, it could also sustainably release bacteria-killing Ag+ to obtain an antibacterial ratio of 95.1 % and ensure a long-term antibacterial effect. In addition, the optimal S-Ag/ZrO2 sample having this structure showed a PC12 cell survival rate of up to 81.75 %, demonstrating its good biocompatibility. This work may be of great inspiration and reference for the expansion of the use of ZrO2 in dentistry.