A surface modification technique was developed for the covalent immobilization of poly(vinyl alcohol) (PVA) hydrogel onto poly(ethylene terephthalate) (PET) to improve the biocompatibility of the film. The PET film was first graft copolymerized with poly(ethylene glycol) monomethacrylate (PEGMA) in the presence of ethylene glycol dimethacrylate (EGDMA) as crosslinker, and then oxidized with a mixture of acetic anhydride (Ac2O) and dimethyl sulfoxide (DMSO) to produce aldehyde groups on the PET surface. Finally, the prepared PVA solution was cast onto the film and covalently immobilized on the film through the reaction between the aldehyde groups on the PET film and the hydroxyl groups of PVA. The good attachment of the PVA layer to the PET film was confirmed by observing the cross-section of the PET-PVA film using scanning electron microscopy (SEM). Heparin was immobilized on the PVA layered PET using two different methods, physical entrapment and covalent bonding, to further improve the biocompatibility of the film. Attenuated total reflectance (ATR) FT-IR spectroscopy and X-ray photoclectron spectroscopy (XPS) were used to characterize the chemical composition of the surface modified films. The biocompatibility of the various surface modified PET films was evaluated using plasma recalcification time (PRT) and platelet adhesion. (C) 2004 Elsevier Ltd. All rights reserved.