Although it is well known that fungal biofilms have increased resistance to antimicrobial agents, limited information is available on the formation of candidal biofilms on implant surfaces with different surface roughness and their resistance to conventional antifungal therapy. In the current study, the effect of increasing the surface roughness of titanium discs on the susceptibility of Candida albicans biofilms to amphotericin B was determined. Grade I commercially pure titanium discs were sandblasted with 99.6% aluminium oxide of different grit sizes, producing surface roughness of 0.90, 1.88 and 3.82 microm (Groups A, B and C), respectively (P < 0.001). The antifungal susceptibility of C. albicans biofilm grown on different Ti discs was determined using XTT assay. The 50% reduction in metabolic activity (50% RMA) of planktonic C. albicans (0.5 microg/mL) was much lower than those from Groups A, B and C (2, 16, 2 microg/mL, respectively), while the 50% RMA from Group B was three-fold higher than those from Groups A and C. In conclusion, difference in titanium surface roughness was associated with variations in the antifungal resistance of the candidal biofilm. Group C appeared to have an optimum surface roughness for biofilm resistance.