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In this study, a pseudozwitterionic surface bearing positively and negatively mixed charged moieties was developed as a potential hemocompatible material for biomedical applications. In this work, hemocompatility of pseudozwitterionic surface prepared from copolymerization of negatively charged 3-sulfopropyl methacrylate (SA) and positively charged [2-(methacryloyloxy)ethyl] trimethylammonium (TMA) was delineated. Mixed charge distribution in the prepared poly(TMA-co-SA)-grafted surface can be controlled by regulating TMA and SA monomer ratios via surface-initiated atom transfer radical polymerization. The effects of grafting composition and charge bias variations on blood compatibility of poly(TMA-co-SA)-grafted surface were reported. The protein adsorption on different poly(TMA-co-SA)-grafted surfaces from human plasma protein (fibrinogen, HSA, and?-globulin) solutions was evaluated using an enzyme-linked immunosorbent assay. Blood platelet adhesion and time measurements on plasma clotting were conducted to determine the platelet activation on the grafted surface. It was found that the protein resistance and anti-blood cell adhesion of prepared surface can be precisely controlled by controlling the charge balance of TMA/SA compositions. In addition, different charge bias variations on the poly(TMA-co-SA)-grafted surface would induce electrostatic interactions between plasma proteins and prepared surfaces which lead to adsorptions of interfacial protein and blood cells, plasma clotting, and blood cell hemolysis. Results from this study suggest that the hemocompatility of mixed charged poly(TMA-co-SA)-grafted surface depends on the charge bias level. This provides a great potential for designing biomaterial with unique surface chemical structure which could be used in contact with human blood. [ABSTRACT FROM AUTHOR]