<p>During surgical procedures, medical cutting tools often suffer from phenomena such as adhesion, which greatly reduces their cutting efficiency. Surface microtexturing has been shown to reduce friction, increase wear resistance, and reduce noise, and the processing of different microtextures on the surface of medical tools can improve tool performance. However, microtextures produced by different methods show different results. First, several microtexturing methods are introduced, describing the processing technology’s principles, characteristics, and problems that may occur during processing. Second, the current situation of applying non-smooth structures in medical cutting tools such as general scalpels, high-frequency electric knives, and bone drills is summarized. Then, the influence law of non-smooth structures on cutting performance is analyzed in terms of cutting force, cutting temperature, tool wear, and the amount of soft tissue adhesion. Finally, some urgent issues and observations are presented to provide new inspirations for designing future microtexture medical cutting tools.</p>