In this study, integrin expression, proliferation, and endothelial differentiation of adipose-derived stem cells (ADSCs) on pristine cobalt chrome (CoCr) surface, microstructured and nanostructured CoCr surfaces (obtained after treatment with piranha solution) were investigated. The results showed that proliferation of ADSCs on the substrates treated with piranha solution is not significantly different from that on the pristine substrates. However, quantitative real-time PCR analysis showed significantly enhanced up-regulation of CD31, vWF and eNOS from gene level by ADSCs on the nanostructured substrates but not on the microstructured substrates. The adsorption of vitronectin from the culture medium on the nanostructured substrates was higher than on the pristine and microstructured substrates. We speculate that this results in increased integrin αvβ3 expression in the ADSCs, which may contribute partially to the enhanced endothelial differentiation of ADSCs on the nanostructured substrates. This study shows that ADSCs can be used to endothelialize stents in vitro and the endothelial differentiation of ADSC is enhanced on the nanostructured surfaces.