A study of the surface modification of titanium CP grade 2 implant/target with high intensity picosecond (Nd:YAG) laser, operating at 1064 nm wavelength and pulse duration of 40 ps, in gaseous (air) and liquid (water) medium, is presented. The exposure of Ti to a laser pulse energy of 17 mJ in both media – gaseous and liquid, induced specific surface features and phenomena: (i) enhancement of the implant surface roughness (higher in water). In this context, the damage depth is more prominent in water (as high as ∼40 μm) vs. air (∼14 μm). Also, the appearance of laser induced periodic surface structures (LIPSS) is recorded in both media, at periphery area, while in water they are registered at lower pulse count; (ii) variation of chemical surface content depending on the applied medium. Thus, in the central irradiation region, the oxygen was absent in air while its concentration was relatively high (6.44 wt%) in case of water; (iii) possibility of direct collection of synthesized titanium based nanoparticles in water environment, and (iv) formation of the plasma above the sample in both mediums, more volumetrically confined in water. These investigations showed that surface structuring and observed phenomena are in strong correlation with the medium used. The liquid – water seems like the medium of choice in regard to titanium implant biocompatibility and bio-activity (the water is a favorable medium for build-up of the oxide layer which affects bioactivity). The process of laser interaction with titanium implant targets was accompanied by the formation of plasma plume, which provides the additional sterilizing effect facilitating contaminant-free conditions. © 2017 Elsevier B.V.