A series of amphiphilic alternative block polyurethane copolymers based on poly(3-hydroxybutyrate-co-4-hydroxybutyrate) (P3/4HB) and poly(ethylene glycol) (PEG) were synthesized by a facile way of coupling reaction between P3/4HB-diol and PEG-diisocyanate, with different 3HB, 4HB, PEG compositions and segment lengths. Stannous octanoate was used as catalyst. The chemical structure, alternative block arrangement, molecular weight and distribution were systematically characterized by FTIR, 1H NMR, GPC and composition analysis. The thermal property was studied by DSC and TGA. Platelet adhesion study revealed that the alternative block polyurethanes possess excellent hemocompatibility. CCK-8 assay illuminated that the nontoxic block polyurethanes maintain rat aortic smooth muscle cells (RaSMCs) good viability. The in-vitro degradation of the copolymers in PBS buffer solution and in lipase buffer medium was investigated. Results showed that the copolymer films exhibit different degradation patterns in different media from surface erosion to diffusion bulk collapsing. The synthetic methodology for the alternative block polyurethanes provides a way to control the exact structure of the biomaterials and tailor the properties to subtle requirements.