Nanoscale topographies and chemical patterns can be used as synthetic cell interfaces with a range of applications including the study and control of cellular processes. Herein, we describe the fabrication of high aspect ratio nanostructures using electron beam lithography in the epoxy-based polymer SU-8. We show how nanostructure geometry, position and fluorescence properties can be tuned, allowing flexible device design. Further, thiol-epoxide reactions were developed to give effective and specific modification of SU-8 surface chemistry. SU-8 nanostructures were made directly on glass cover slips, enabling the use of high resolution optical techniques such as live-cell confocal, total internal reflection and 3D structured illumination microscopy to investigate cell interactions with the nanostructures. Details of cell adherence and spreading, plasma membrane conformation and actin organization in response to high aspect ratio nanopillars and nanolines were investigated. The versatile structural and chemical properties combined with the high resolution cell imaging capabilities of this system are an important step towards the better understanding and control of cell interactions with nanomaterials.