Anti-microbial coatings and powders and method of forming same on medical devices are provides. The coatings are preferably formed by depositing an anti-microbial biocompatible metal by vapour deposition techniques to produce atomic disorder in the coating such that a sustained release of metal ions sufficient to produce an anti-microbial effect is achieved. Preferred deposition conditions to achieve atomic disorder include a lower than normal substrate temperature, and one or more of a higher than normal working gas pressure and a lower than normal angle of incidence of coating flux. Anti-microbial powders formed by vapour deposition or altered by mechanical working to produce atomic disorder are also provided. The anti-microbial effect of the coatings or powders may be further activated or enhanced by irradiating with a low linear energy transfer form of radiation such as gamma radiation. Novel anti-microbial silver materials are defined, characterized by having a positive rest potential, a Trec/Tm less than 0.33, and a grain size less than 200 nm. Anti-microbial fine grain or nanocrystalline materials are provided, together with methods of preparation, wherein the anti-microbial metal if deposited in a matrix with atoms or molecules of a different material such as other biocompatible metals (ex. Ta), trapped or absorbed oxygen, or compounds of anti-microbial metals or biocompatible metals (ex. Ag0 or TaO). The invention also extends to a method of producing an anti-microbial effect with silver materials that form complex silver ions other than Ag , Ag and Ag .