Interactions between cells and surfaces during the surface attachment process, collectively referred to as cell-surface interactions, is an active field of research with implications in medical technologies, environmental sciences, and industrial engineering. Specifically, cell-surface interactions between bacteria and nanotopographies with high aspect ratio protrusions, or nanopillars, have the potential to exhibit antibacterial capabilities by mechanical means, though these antibacterial interactions are poorly understood. In this thesis, a mechanism was first proposed to explain the rapid mechano-bactericidal effect observed on model nanopillars synthesized from zinc oxide: External normal forces, such as that from the surface tension of an air-liquid interface or from an applied downward force, play a crucial role in acute mechano-bactericidal effects of the nanopillars. Conversely, the absence of normal forces yielded negligible acute antibacterial effects. Next, aspects of the bacterial attachment cycle on zinc oxide nanopillars were investigated, including initial attachment to the nanopillars, possible proliferation on the nanopillars, and detachment of inactivated bacteria from the nanopillars. Based on a microfluidic study of initial attachment, bacterial attachment was found to be dependent on nanopillar geometry and topography. Regardless of species, bacteria attached poorly on a high density of smaller nanopillars, thus this geometry can potentially offer anti-biofouling functions. To observe acute inactivation and possible long-term recovery of bacteria on the nanopillars, luminescence of a recombinant bacterial strain expressing bioluminescence was monitored in real time. Both acute and long-term mechano-bactericidal effects were more pronounced on a low surface density of wider nanopillars, whereas a high density of smaller nanopillars had minimal bactericidal effects. Finally, spontaneous detachment of live or inactivated bacteria from stainless steel coated with zinc oxide nanopillars was possible, but results varied greatly. A proposed electrochemical process to remove biofouled nanopillars proved highly effective in restoring the nanopillar topography against some types of biofouling. Overall, the studies in this thesis contribute toward the future application of mechano-bactericidal nanopillar as antibacterial surface coatings