A scalable, prototype plasmonic nanomanufacturing system was designed, built, and tested for patterning nanostructures on the surfaces of drug-eluting stents (DES), the objective being to prevent the late-stent thrombosis (LST). Nanopatterning, unlike micro/macropatterning, of DES has proven to provide optimal, rapid, and preferential endothelial cell (EC) attachment (antithrombosis) while not significantly affecting shear-mediated platelet activation (prothrombosis). In this work, laser-induced, high-density surface plasmon polaritons (SPPs) were generated and utilized to produce nanostructures on the surfaces of DES by electric field enhancement mechanism. The scalability aspects such as downsizing the feature, improving the precision, increasing the throughput, and reducing the cost were investigated. Results indicated fairly uniform nanostructures; high throughput; excellent repeatability and resolution; significant cost savings; and potential for high retention of drug dose in the stent. The work represents an unprecedented area in nanomanufacturing where the basic science contribution is to harness the energy from plasmon polaritons by effectively “customizing” and “controlling” their propagation, while the engineering contribution is a scalability approach to reliably nanopattern medical devices in high volume with nanometer resolution. The nanomanufacturing system developed in this study may be an enabling technology to strongly impact other fields such as semiconductors, organic solar cells, and nano-electromechanical systems (NEMS).