Double glow plasma surface alloying (DGPSA) technology is a fascinating strategy for modifying metal materials with promoted surface performances. Especially after nearly 40 years of development, this technology has played an increasing role in biomedical metal surface modification to improve antibacterial ability, biocompatibility, osteogenic activity, etc. This review briefly overviews surface modification of biomedical metals by DGPSA technology. The origin and development, fundamental mechanism, and coating characteristics of DGPSA technology, the recent progress of DGPSA technology in preparing coatings for antibacterial application (e.g., silver-based coatings, copper-based coatings, multimetallic antibacterial coatings), as well as coatings for implantable application (e.g., tantalum-based coatings, zirconium-based coatings, and niobium-based coatings), are summarized. Notably, the respective design consideration, characteristics, and properties of each coating have been consistently reviewed. This technology has significant advantages in preparing biomedical metallic coatings with high bonding strength, regardless of the high melting point of the target metals. Thus, we firmly believe that, by combining with practical target design, ‘DGPSA +’ strategy, and systematic performance evaluation, this new emerging technology will find its further development in surface modification of biomedical metals.
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