To evaluate the platelet adhesion ability on pure titanium surfaces modified with different techniques. Pure titanium specimens were treated with 5 different surface modification techniques, including machine polish (MP), dual acid-etch (DAE), sand blast-large grit and acid-etch (SLA), micro-arc oxidation (MAO) and anodized titania nanotube (TNT). The surface topographies of specimens were observed by scanning electron microscopy (SEM). Chemical compositions, surface roughness and static water contact angle of specimens were detected by energy dispersive spectrometer (EDS), laser scanning confocal microscope (LSCM) and contact angle analyzer respectively. Platelets were cultured on specimen surfaces for 30 min. The amount and viability of adhered platelets adhered were evaluated. Platelet distribution and morphology were observed by LSCM and SEM. Surface topographies of the five groups of specimens differed significantly. MP, DAE, SLA and MAO surfaces showed micro-scale topographies, while TNT surfaces showed nano-scale topography with nanotubes at the diameter of (80.46 ± 0.35) nm. The surface roughness of MAO was the highest among the 5 groups. TNT surfaces demonstrated the lowest roughness as well as the lowest static water contact angle as 13.55° ± 0.96°. The amount of platelets adhered on TNT surface was the greatest as (300 729 ± 8 325) platelet/µl and the viability was the highest (A450 value 2.14 ± 0.05). Platelet adhered intensively on TNT surfaces, forming pseudopodia, extending and connecting with each other. Surface properties of pure titanium affect platelet adhesion ability. Nano-scale topography can greatly improve platelet adhesion. Increased surface roughness and hydrophilicity can improve platelet adhesion ability.