The wear properties of ceramic pairs including a biomedical grade zirconia ceramic (PROZYR®) were studied. In a simple disk-on-disk wear test in synthetic serum, the best wear behavior was observed with alumina-zirconia pairing. These tests also showed that the zirconia-zirconia combination can be considered for hip joint applications because it demonstrates wear behavior close to the classic alumina-alumina pairing. Hip simulator tests up to 10 million cycles for zirconia-alumina combinations confirm the previous experiments. It is clearly shown, if zirconia ceramic material and convenient wear test procedures are used, that the wear behavior of zirconia ceramic in ceramic-ceramic pairing is outstanding. The wear performance of zirconia was similar to, if not better than, that of alumina. Furthermore, tensile stresses in heads and cups, determined using finite element analysis, were found to be significantly higher in ceramic-on-ceramic bearings than in conventional ceramic-on-polyethylene couplings. This may influence the incidence of ceramic component fractures in ceramic-on ceramic bearings and may have implications concerning ceramic material selection for this application.