Owing to good biocompatibility, good fatigue resistance, and excellent superelasticity, various types of bio-medical devices based on NiTi shape memory alloy (SMA) have been developed. Due to the complexity in deformation mode in service, for example NiTi implants, accurate assessment/prediction of the surface wear process is difficult. This study aims at providing a further insight into the effect of deformation mode on the wear behavior of NiTi SMA. In the present study, two types of wear testing modes were used, namely sliding wear mode and reciprocating wear mode, to investigate the effect of deformation mode on the wear behavior of NiTi SMA in both martensitic and austenitic states. It was found that, when in martensitic state and under high applied loads, sliding wear mode resulted in more surface damage as compared to that under reciprocating wear mode. When in austenitic state, although similar trends in the coefficient of friction were observed, the coefficient of friction and surface damage in general is less under reciprocating mode than under sliding mode. These observations were further discussed in terms of different deformation mechanisms involved in the wear tests, in particular, the reversibility of martensite variant reorientation and stress-induced phase transformation, respectively. © 2016, ASM International.