A one-step method was developed to create a highly biocompatible micropatterned surface on a diamond-like carbon (DLC) through irradiation with a nitrogen ion beam and thus enhance the biocompatibility of osseointegrated surfaces and biotribological performance of articular surfaces. The biocompatibility and biotribological mechanisms were analyzed in terms of the structure and morphology of DLC. It was demonstrated that a layer enriched in sp3 C−N bonds was formed on the surface of the DLC after nitrogen ion beam irradiation. Moreover, with an increase in the radiation dose, the content of sp3 C−N on the DLC surface increased significantly, and the biocompatibility was positively correlated with it. The adhesion of the MC3T3 osteoblasts increased significantly from 32% to 86% under an irradiation dose of 8 × 1015 ions/cm2. In contrast, the micropattern had a significant negative effect on the adhesion of the osteoblasts as it physically hindered cell expansion and extension. The micropattern with a depth of 37 nm exhibited good friction properties, and the coefficient of friction was reduced by 21% at relatively high speeds.