Structured surfaces at the micro- and nanoscale enable precise control of cell–material interactions in tissue engineering and regenerative medicine (TERM). This keynote examines scalable manufacturing methods for 2D substrates, 3D scaffolds, and implants, analyzing relationships between topography, biological performance, and process efficiency. Key technologies include nanoimprint lithography, micro injection molding, high-resolution additive manufacturing, and ultrafast laser texturing. Strategies for combining biological efficacy with cost-effective production are presented, along with multifunctional designs for osseointegration and antibacterial activity. Future perspectives address biomimetic and patient-specific structures, process–function modeling, and smart materials to support advanced TERM applications and clinical translation.