An overview about carbon nanotube (CNT) production and quality parameters will be presented, as well a review of current literature about "in vitro"assays commonly used to evaluate the biocompatibility of CNT. The limits of colorimetric assays for CNTs evaluation will be discussed, using comparisons between dispersed CNT and CNT arrays. The influence of nanotopography and wettability of CNT scaffolds for cell adhesion will be shown. Studies carried out in our laboratories with vertically-aligned carbon nanotubes (VACNT) will also be presented. We have shown the interaction among CNT (VACNT) and four cell lines: mouse fibroblasts (L-929), mouse embryo fibroblast (C57/BL6) with or without green fluorescent protein (GFP) and human osteoblast (SaOS-2). The biocompatibility tests were performed with in vitro tests on raw-VACNT and after superficial modification by O2 plasma, which changes its hydrophobic character. The non-toxicity, cell viability, proliferation and cell adhesion were evaluated by: (i) 2-(4,5-dimethyl-2-thioazoly)-3,5-diphenyl-2H-tetrazolium bromide (MTT) assay; (ii) Lactate dehydrogenase (LDH) assay; (iii) neutral red (NR) assay; (iv) Scanning electron microscopy (SEM); and fluorescence microscopy. The influence of catalyst type, VACNT density and superficial modification were evaluated by morphological, structural and superficial techniques: SEM, Transmission electron microscopy (TEM), Raman spectroscopy, contact angle (CA) and X-Ray Photoelectron Spectroscopy (XPS). High cell viability, exceptional cell adhesion and preference were achieved. © 2009 by Nova Science Publishers, Inc. 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