Poly(butylene succinate), a novel biodegradable aliphatic polyester with excellent processability and mechanical properties, was modified by O(2) or N(2) plasma immersion ion implantation (PIII). X-ray photoelectron spectroscopy and contact angle measurements were carried out to reveal the surface characteristics of the treated and control specimens. The in vitro effects of the materials on seeded osteoblasts were detected by cell viability assay, alkaline phosphatase activity test, and real-time polymerase chain reaction analysis. Plate counting was performed to investigate the antibacterial properties. Our results show that both PIII treatments significantly improve the hydrophilicity of PBSu, and CO and nitrogen groups (CNH and CNH(2)) can be detected on the PBSu after O(2) and N(2) PIII, respectively. The modified samples exhibit similar compatibility to osteoblasts, which is better than that of the control, but O(2) PIII and N(2) PIII produce different effects according to the osteogenic gene expressions of seeded osteoblasts on the materials. Moreover, the N(2) plasma-modified PBSu exhibits anti-infection effects against Staphylococcus aureus and Escherichia coli but no such effects can be achieved after O(2) PIII.