This paper reports polymethyl methacrylate (PMMA) surface modification by atmospheric-pressure oxygen dielectric barrier discharge (DBD) plasma to improve its biocompatibility and antibacterial effects. The role of plasma system parameters, such as electrode gap, treatment time and applied voltage, on the surface characteristics and biological responses was studied. The surface characteristics of PMMA films before and after the plasma treatments were analyzed by water contact angle (WCA) goniometry, atomic force microscopy (AFM) and attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR). Also, acid-base approach was used for evaluation of surface free energy (SFE) and its components. Stability of plasma treatment or aging effect was examined by repeating water contact angle measurements in a period of 9 days after treatment. Moreover, the antibacterial properties of samples were investigated by bacterial adhesion assay against Escherichia coli. Additionally, all samples were tested for the biocompatibility by cell viability assay of mouse embryonic fibroblast. WCA measurements indicated that the surface wettability of PMMA films was improved by increasing surface free energy via oxygen DBD plasma treatments. AFM measurement revealed that surface roughness was slightly increased after treatments, and ATR-FTIR analysis showed that more polar groups were introduced on the plasma-treated PMMA film surface. The results also demonstrated an enhancement of antibacterial performance of the modified surfaces. Furthermore, it was observed that plasma-treated samples exhibited significantly better biocompatibility, comparing to the pristine one. (C) 2015 Elsevier B.V. All rights reserved.