Adhesion of bacteria and platelets on blood-contact implants and surgical devices is one of the causes of infections and thrombus. A superhydrophobic surface serving as a protective layer can minimize adhesion and contamination due to the low surface energy. The objective of this paper is to construct a superhydrophobic surface on a titanium implant by a combination of a topological structure and chemical coating. First, a micro/nano hierarchical morphology is obtained by sandblasting, acid-etching, and anodic oxidation. Then, a low surface energy coating material (fluoroalkylsilane, as the example case in this study) is used to modify the surface further. The effects of the morphology of micro and/or nanoscales and corresponding fluorination on the wettability are investigated. The results show that a hierarchical surface with microroughness and nanotubes is successfully constructed, and the contact angle (CA) is 44.9°, indicating good hydrophilicity. Interestingly, after being modified by fluoroalkylsilane, the surface converted from hydrophilic to superhydrophobic with a CA of 151.4°. In contrast, the fluorination modification of single micro or nanofeatures cannot achieve superhydrophobicity, indicating that the micro/nanostructures may show a synergistic effect for an efficient fluorination coating later on. Overall, our results demonstrate the feasibility of achieving a superhydrophobic surface via the micro/nano topological patterning and fluorination modification. The proposed method is expected to enrich the preparation technologies of superhydrophobic titanium surfaces. Graphic abstract