Micronuclei tests (MNT) using the Chinese Hamster Ovary (CHO) cells and Chinese Hamster Ovary Mutant cells (XRS5) have been conducted to evaluate the biocompatibility of silicon and titanium plasma-implanted silicon. Pure Si induces high MN ratios of the two cell lines and thus has poor biocompatibility. The MN ratio of CHO cells is higher than background by about 44% and the MN ratio of XRS5 cells is even higher by about 180%, suggesting that most of the cellular DNA damages on the Si wafer are DNA double-strand breaks (DSB) and are efficiently repaired by the nonhomologous end-joining (NHEJ) pathway. The surface biocompatibility of Si can be enhanced by Ti plasma immersion ion implantation (PIII). The altered oxidized species on the Ti plasma-implanted surface block cellular DSB repaired by the NHEJ pathway and decrease the MN ratio of XRS5 cells. By increasing the Ti implantation time and consequently the Ti implant fluence, the oxygen binding energy shifts toward a lower energy and the intensity of the Si peaks corresponding to SiO(2) continually diminishes and even disappear. At the same time, the MN ratios of the two cell lines decrease. Our results suggest that the rest of the DNA damages which cannot be repaired by the NHEJ pathway may be blocked because the surface bonding changes from predominantly Si-O on the 10 min Ti-implanted Si to Ti-O on the 120 min Ti-implanted Si. Our results also suggest that the genotoxicity of cell assay such as MNT and DSB is a valid method to investigate biocompatibility.