A group of novel cross-linked polyurethane materials with varying ratios of hydroxyl-terminated macrodiols and tethered quaternary ammonium biocides have been prepared. The resulting materials had a wide range of thermal, mechanical, and surface properties, dictated by the macrodiol composition and biocide concentration. The complex interplay between surface chemistry and biocide concentration was shown to have a profound effect on the fouling resistance of these materials. While the combination of quaternary ammonium salt (QAS) diols with poly(tetramethylene oxide) macrodiols did not result in any enhancement of fouling resistance, addition of biocides to poly(ethylene glycol)-containing urethanes resulted in up to a 90% increase in biocidal activity compared to control materials while reducing the ability for microbes to adhere to the surface by an additional 60%. Materials prepared with polybutadiene macrodiols underwent a thermally induced oxidation, resulting in partial decomposition of the quaternary ammonium salt biocide and joint antimicrobial activity arising from remaining QAS and peroxide compounds.