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Magnesium alloys have tremendous potential for biomedical applications due to their good biocompatibility, osteoconductivity, and degradability, but can be limited by their poor mechanical properties and fast corrosion in the physiological environment. In this study, ultrasonic nanocrystal surface modification (UNSM), a recently developed surface processing technique that utilizes ultrasonic impacts to induce plastic strain on metal surfaces, was applied to an AZ31B magnesium (Mg) alloy. The mechanical properties, corrosion resistance, and biocompatibility of the alloy after UNSM treatment were studied systematically. Significant improvement in hardness, yield stress and wear resistance was achieved after the UNSM treatment. In addition, the corrosion behavior of UNSM-treated AZ31B was not compromised compared with the untreated samples, as demonstrated by the weight loss and released element concentrations of Mg and Al after immersion in alpha-minimum essential medium (α-MEM) for 24 h. The in vitro biocompatibility of the AZ31B Mg alloys toward adipose-derived stem cells (ADSCs) before and after UNSM processing was also evaluated using a cell culture study. Comparable cell attachments were achieved between the two groups. These studies showed that UNSM could significantly improve the mechanical properties of Mg alloys without compromising their corrosion rate and biocompatibility in vitro . These findings suggest that UNSM is a promising method to treat biodegradable Mg alloys for orthopaedic applications. [ABSTRACT FROM AUTHOR]