Surface texture (ST) has been confirmed as an effective and economical surface treatment technique that can be applied to a great range of materials and presents growing interests in various engineering fields. Ti6Al4V which is the most frequently and successfully used titanium alloy has long been restricted in tribological-related operations due to the shortcomings of low surface hardness, high friction coefficient, and poor abrasive wear resistance. Ti6Al4V has benefited from surface texture-based surface treatments over the last decade. This review begins with a brief introduction, analysis approaches, and processing methods of surface texture. The specific applications of the surface texture-based surface treatments for improving surface performance of Ti6Al4V are thoroughly reviewed from the point of view of tribology and biology.