Abstract: Polyetheretherketone (PEEK) is a prominent candidate for hard tissue implants to replace traditional biomedical metallic materials due to its outstanding biocompatibility and elastic modulus analogous to the human cortical bone. However, there is insufficient bioactivity for PEEK, thus resulting in a difficulty in application for hard tissue implants. This paper reviewed the research progress in bioactive enhancement of PEEK by surface modification. At first, the surface coating of hydroxyapatite and titanium dioxide for PEEK was considered as primary modification techniques such as plasma spraying and spin coating, which could endow PEEK with bioactivity. Moreover, the direct surface modification strategies were also widely adopted to enhance the bioactivity of PEEK. These strategies included plasma immersion ion implantation, laser treatment and chemical surface wetting. Bacterial infection was broadly recognized as one of the main causes of implant failure. Therefore, the enhancement of the bioactivity and antibacterial capability of PEEK implants by surface modification has become the hot topics in recent years. This paper introduced the recent research status of these surface modification techniques for bioactive enhancement of PEEK and also prospected its development direction in future.