An optimized low-temperature plasma carbonitriding process at 430°C for 15h was used to treat the surface of 316LVM medical grade austenitic stainless steel. By using a servo-hydraulic dynamic test machine, the fretting behaviour of both as-received and the surface-treated 316LVM plate samples against martensitic stainless steel balls was studied in the Ringer's solution at various displacement amplitudes. The experimental results demonstrate that the optimized low-temperature plasma surface treatment can produce a precipitate-free, C/N supersaturated S-phase layer. Such layer revealed a hardness of 5 times that of 316LVM substrate. The formation of S-phase can protect the 316LVM from corrosion in the Ringer's solution, and the hard surface-treated layer can significantly improve the fretting wear resistance of 316LVM material. When fretted in a mixed regime, a sharp drop of friction force was observed for untreated 316LVM after fretting for about 1000 cycles, which was mainly caused by the penetration of Ringer's solution into the contact area of the fretting pairs. As a comparison, no friction drop was observed through the fretting process on the surface-treated samples. Due to the high ratio of elastic modulus to hardness (E/H) of untreated sample, the main damage mechanism on untreated sample was adhesive and abrasive wear during the fretting process. However, because of the high hardness and low E/H ratio of the surface-treated sample, the main damage mechanism was mild abrasive wear. In conclusion, the low temperature plasma surface treatment can effectively improve the fretting wear properties of 316LVM stainless steel, which could pave the way to develop the high-performance, long-life body implants.