In the present study, a hierarchical micro/nano-scale surface architecture was fabricated on grade 23 Ti alloy adopting a duplex surface treatment (laser micro-texturing coupled with alkaline hydrothermal etching) for functionalizing implantable biomaterials. The susceptibility of the treated alloy to synergistic degradation mechanisms induced by fretting wear and corrosion was assessed in an in-vitro simulated peri-implantation environment. Surface and sub-surface physico-chemical properties correlated with the degradation kinetics have been elucidated, while drawing comparative analyses with the individually treated and untreated alloy. It has been observed that bio-tribocorrosion kinetics significantly reduced on the duplex-treated alloy, attributed to an improved passivation tendency and lowered friction on the hierarchical morphology. The composite mechanical behavior of the overlaying anatase-TiO 2 nanostructures (tough) and a refined sub-surface grain structure (higher hardness) against the fretting loads was also influential in reducing material wear component. In-vitro cytocompatibility studies revealed no induced cytotoxicity on the treated surfaces, with improved cell proliferation and metabolism on the nanostructured and hierarchical surfaces. The role of the micro-features in providing effective contact guidance for cell navigation was also revealed. Finally, the mechano-bactericidal effects imparted by the facile nanoscale features against Gram positive bacteria S. aureus was confirmed through qualitative in-vitro assays. The overall investigation provides valuable insights into the material stability and application suitability of the novel hybrid surface-engineering approach adopted on Ti-6Al-4 V ELI alloy for orthopedic implants.