This article focuses on the surface engineering of ventricular assist devices (VADs) for the treatment of heart failure patients, which involves the modification of surfaces contacting blood in order to improve the blood compatibility (hemocompatibility) of the VADs. Following an introduction to the categorization and the complications of VADs, this article pays attention on the hemocompatibility, applications and limitations of six types of surface coatings for VADs: titanium nitride coatings, diamond-like carbon coatings, 2-methacryloyloxyethyl phosphorylcholine polymer coatings, heparin coatings, textured surfaces and endothelial cell linings. In particular, diamond-like coatings and heparin coatings are the most commonly used for VADs owing to their excellent hemocompatibility, durability and technical maturity. For high performance and a long lifetime of VADs, surface modification with coatings to ensure hemocompatibility is as important as the mechanical design of the device.